Abdullah Chughtai, DMD
Individual provider Active NPI General Practice Dentistry · Rock Falls, IL
NPI 1144735978 · NPPES record last updated Dec 1, 2017
Key facts
- NPI
- 1144735978
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019.031454 (IL)
- Practice address
- 1300 W 2ND St
Rock Falls, IL 61071-1005 - Phone
- (815) 626-2230
- Fax
- (815) 626-2231
- NPI assigned
- Dec 1, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180521000092 | IL | Order and Referring Only - Dentist |
4082979190 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.031454 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.031454 | IL | Yes |
Addresses
Primary practice location
1300 W 2ND St
Rock Falls, IL 61071-1005
Mailing address
1300 W 2ND St
Rock Falls, IL 61071-1005
Phone (815) 626-2230
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All providers in Rock Falls, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.