NPIMap

Organization Active NPI

Wesley C. Wise, DDS & Associates, LTD

  • General Practice Dentistry
  • Oak Park, IL
National Provider Identifier
1114046398
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019013316 Issued in IL
Legal business name
WESLEY C. WISE, DDS & ASSOCIATES, LTD
Practice address
137 N Oak Park Ave Ste 202
Oak Park, IL 60301-1340
Phone
(708) 524-0330
Fax
(708) 524-0136
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mickie Kerr
Title
Office Manager
Phone
(708) 524-0330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019013316 IL Primary

Addresses

Primary practice location

137 N Oak Park Ave Ste 202
Oak Park, IL 60301-1340

Mailing address

137 N Oak Park Ave
Suite 202
Oak Park, IL 60301-1344
Phone (708) 524-0330

Other names 1

  • M.E. Brundage, DDS & W. C. Wise DDS, LTD Former legal business name

National Provider Directory

National Provider Directory

Locations

137 N Oak Park Ave
Ste 202
Oak Park, IL 60301
Phone (708) 524-0330

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1114046398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE",
            "address_2": "SUITE 202",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011344",
            "telephone_number": "708-524-0330",
            "fax_number": "708-524-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE STE 202",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011340",
            "telephone_number": "708-524-0330",
            "fax_number": "708-524-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY C. WISE, DDS & ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "KERR",
        "authorized_official_first_name": "MICKIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-524-0330"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019013316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M.E. Brundage, DDS & W. C. Wise DDS, LTD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.