Individual provider Active NPI

Andrea M Miller Finch, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1124028113
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019022059 Issued in IL
Practice address
1625 W North Ave Apt 1a-1E
Chicago, IL 60622-8415
Phone
(312) 208-4977
Fax
(312) 208-4977
NPI assigned
Jul 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019022059 IL
General Practice Dentistry 1223G0001X 019022059 IL Primary

Addresses

Primary practice location

1625 W North Ave Apt 1a-1E
Chicago, IL 60622-8415

Mailing address

1625 W North Ave Apt 1a-1E
Chicago, IL 60622-8415
Phone (312) 208-4977

Other identifiers 2

IdentifierTypeStateIssuer
1002966MedicaidIL
1245401124OtherILNPI TYPE 2 ORGANIZATION

Other names 1

  • Dr. Andrea M Miller Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230208000062 IL Practitioner - Dentist 1052783636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
019022059ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Athena Dental Institute P C General Practice Current Accepting new patients
Cook County Current Accepting new patients
Athena Dental Institute, P.C. General Practice Current Accepting new patients
Cook County CurrentSince Feb 16, 2023 Accepting new patients
Cook County CurrentSince Feb 16, 2023 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1124028113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 W NORTH AVE APT 1A-1E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228415",
            "telephone_number": "312-208-4977",
            "fax_number": "312-208-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 W NORTH AVE APT 1A-1E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228415",
            "telephone_number": "312-208-4977",
            "fax_number": "312-208-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER FINCH",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-30",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022059",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002966",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2 ORGANIZATION",
            "identifier": "1245401124",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MILLER",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.