NPIMap

Organization Active NPI

James L Derrico DDS

  • Dentist
  • Lisle, IL
National Provider Identifier
1144604224
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.019814 Issued in IL
Legal business name
JAMES L DERRICO DDS
Practice address
6448 College Rd
Lisle, IL 60532-3290
Phone
(630) 983-8700
Fax
(630) 983-8512
NPI assigned
Jul 17, 2015
Last updated
Jul 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
James L. Derrico, DDSNPI 1891801585
Title
Owner
Phone
(630) 983-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU
Dentist 122300000X 019.019814 IL Primary

Addresses

Primary practice location

6448 College Rd
Lisle, IL 60532-3290

Mailing address

6448 College Rd
Lisle, IL 60532-3290
Phone (630) 983-8700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1144604224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6448 COLLEGE RD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323290",
            "telephone_number": "630-983-8700",
            "fax_number": "630-983-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6448 COLLEGE RD",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323290",
            "telephone_number": "630-983-8700",
            "fax_number": "630-983-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES L DERRICO DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "DERRICO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-983-8700",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.019814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.