Scott E Berdelle

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019016594 Issued in IL

Practice address

990 Grand Canyon Pkwy
Suite #410
Hoffman Estates, IL 60169-1739

Phone

(847) 885-4343

Fax

(847) 885-4382

NPI assigned

Jul 7, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1124281407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PKWY",
            "address_2": "SUITE #410",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691739",
            "telephone_number": "847-885-4343",
            "fax_number": "847-885-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PKWY",
            "address_2": "SUITE #410",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691739",
            "telephone_number": "847-885-4343",
            "fax_number": "847-885-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERDELLE",
        "first_name": "SCOTT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019016594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria G. Bellantuono, LCPC
• Rachael L Benbrook, LCSW
• Coree H Benesch
• Atlanta Benjamin, DC
• Jody Lynne Benson, OTR/L MS
• John Berent, DPT
• Colleen C Berg
• Jennifer Berghorn, CADC
• Lawrence A Bergman, MD
• Kelly Rose Berk

• General Practice Dentistry in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.