Active NPI
Katrina Louise Orourke, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1194954487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019028449
- Practice address
- 111 N Wabash Ave Ste 1107
Chicago, IL 60602-3123 - Phone
- (312) 609-1300
- Fax
- (312) 609-1308
- NPI assigned
- Jul 7, 2009
- Last updated
- May 21, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019028449 | IL | Primary |
Addresses
Primary practice location
111 N Wabash Ave Ste 1107
Chicago, IL 60602-3123
Mailing address
111 N Wabash Ave Ste 1107
Chicago, IL 60602-3123
Phone (312) 609-1300
Other names 1
- Dr. Katrina Louise Baeverstad
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151209000700 | IL | Order and Referring Only - Oral Surgery | 5991006322 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Katrina Baeverstad DDS LLC | Current | Accepting new patients | |
| Meadows Dental Group | Past | Accepting new patients |
Locations
111 N Wabash Ave
Ste 1107
Chicago, IL 60602
Phone (312) 609-1300
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716249600000",
"number": "1194954487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N WABASH AVE STE 1107",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606023123",
"telephone_number": "312-609-1300",
"fax_number": "312-609-1308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N WABASH AVE STE 1107",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606023123",
"telephone_number": "312-609-1300",
"fax_number": "312-609-1308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OROURKE",
"first_name": "KATRINA",
"middle_name": "LOUISE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-07",
"last_updated": "2024-05-21",
"certification_date": "2024-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATRINA",
"last_name": "BAEVERSTAD",
"middle_name": "LOUISE",
"prefix": "DR.",
"code": "2",
"type": "Professional Name"
}
]
}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 May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.