Active NPI
Henry Michael Kotlinski, D.D.S.
- Dentist
- Chicago, IL
National Provider Identifier
1184809568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019020980
- Practice address
- 5804 W Addison St
Chicago, IL 60634-4358 - Phone
- (773) 736-5525
- Fax
- (773) 736-4811
- NPI assigned
- Jan 4, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019020980 | IL | Primary |
Addresses
Primary practice location
5804 W Addison St
Chicago, IL 60634-4358
Mailing address
5804 W Addison St
Chicago, IL 60634-4358
Phone (773) 736-5525
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 |
|---|---|---|---|
| 019020980 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265673600000",
"number": "1184809568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5804 W ADDISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606344358",
"telephone_number": "773-736-5525",
"fax_number": "773-736-4811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5804 W ADDISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606344358",
"telephone_number": "773-736-5525",
"fax_number": "773-736-4811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTLINSKI",
"first_name": "HENRY",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-04",
"last_updated": "2010-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019020980",
"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 Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.