Active NPI
Stephen D Campbell, DDS
- Prosthodontics
- Chicago, IL
National Provider Identifier
1154534287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- Practice address
- 801 S Paulina St
MC 621
Chicago, IL 60612-7210 - Phone
- (312) 355-1661
- Fax
- (312) 355-3864
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | IL | Primary |
Addresses
Primary practice location
801 S Paulina St
MC 621
Chicago, IL 60612-7210
Mailing address
801 S Paulina St
MC 621
Chicago, IL 60612-7210
Phone (312) 355-1661
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 |
|---|---|---|---|
| 019023051 | IL | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of the University of Illinois | Prosthodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154534287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 S PAULINA ST",
"address_2": "MC 621",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "312-355-1661",
"fax_number": "312-355-3864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S PAULINA ST",
"address_2": "MC 621",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "312-355-1661",
"fax_number": "312-355-3864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "STEPHEN",
"middle_name": "D",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.