Chad Andrew Corley, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-027096 Issued in IL

Practice address

160 W McKinley Ave
Decatur, IL 62526-3223

Phone

(217) 330-6217

Fax

(217) 330-8079

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1134346364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263223",
            "telephone_number": "217-330-6217",
            "fax_number": "217-330-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263223",
            "telephone_number": "217-330-6217",
            "fax_number": "217-330-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "CHAD",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-027096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pompeo Contarin
• Emily J Cook, RD LDN
• Nakita Dorez Cook, FNP
• Robert Cook
• Kenneth Cooper-Williams
• Natalie A Corley, DMD
• Alicia Elaine Corman, MED., OTR/L
• Shannon Michael Cornthwaite, LPC
• Andrew Corzine, PHARMD
• Dennis D Costerisan, D.O.

• General Practice Dentistry in Decatur, IL
• Providers in Decatur, 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 Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.