NPIMap

Organization Active NPI

Hamilton Lakes Dentistry Group, PLLC

  • General Practice Dentistry
  • Itasca, IL
National Provider Identifier
1164181772
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
HAMILTON LAKES DENTISTRY GROUP, PLLC
Practice address
500 Park Blvd Ste 180C
Itasca, IL 60143-3121
Phone
(630) 773-6966
NPI assigned
Dec 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Authorized official

Name
Dr. Kathryn Elizabeth Conti, DDSNPI 1225385701
Title
Owner/General Dentist
Phone
(630) 773-6966

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

500 Park Blvd Ste 180C
Itasca, IL 60143-3121

Mailing address

500 Park Blvd Ste 180C
Itasca, IL 60143-3121
Phone (630) 773-6966

Other identifiers 3

IdentifierTypeStateIssuer
1417000704OtherILNATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM
1598147324OtherILNATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM
1225385701OtherILNATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM

National Provider Directory

National Provider Directory

Locations

500 Park Blvd
Ste 180C
Itasca, IL 60143
Phone (630) 773-6966

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1164181772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PARK BLVD STE 180C",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601433121",
            "telephone_number": "630-773-6966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK BLVD STE 180C",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601433121",
            "telephone_number": "630-773-6966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON LAKES DENTISTRY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "CONTI",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/GENERAL DENTIST",
        "authorized_official_telephone_number": "630-773-6966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM",
            "identifier": "1417000704",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM",
            "identifier": "1598147324",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM",
            "identifier": "1225385701",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Itasca, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.