Active NPI
Frank William Licari, D.D.S.
- Dentist
- Riverside, IL
National Provider Identifier
1124308945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019-020476
- Practice address
- 26 Northgate Rd
Riverside, IL 60546-1639 - Phone
- (708) 447-8437
- NPI assigned
- Aug 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-020476 | IL | Primary |
| Dentist | 122300000X | 4755 | WI |
Addresses
Primary practice location
26 Northgate Rd
Riverside, IL 60546-1639
Mailing address
26 Northgate Rd
Riverside, IL 60546-1639
Phone (708) 447-8437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-020476 | IL | MD | Dentist |
| 4755 | WI | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314144000000",
"number": "1124308945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 NORTHGATE RD",
"city": "RIVERSIDE",
"state": "IL",
"postal_code": "605461639",
"telephone_number": "708-447-8437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 NORTHGATE RD",
"city": "RIVERSIDE",
"state": "IL",
"postal_code": "605461639",
"telephone_number": "708-447-8437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICARI",
"first_name": "FRANK",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-24",
"last_updated": "2011-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-020476",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "4755",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.