Individual provider Active NPI

Faith Lauren Devengencie Chatwin, DDS

  • General Practice Dentistry
  • Libertyville, IL
National Provider Identifier
1205753639
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.037227 Issued in IL
Practice address
712 Florsheim Dr Ste 12
Libertyville, IL 60048-5270
Phone
(847) 573-1904
NPI assigned
Jul 6, 2026
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.037227 IL Primary

Addresses

Primary practice location

712 Florsheim Dr Ste 12
Libertyville, IL 60048-5270

Mailing address

2933 N Sheridan Rd Apt 1210
Chicago, IL 60657-5947
Phone (440) 309-6778

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

LicenseStateTypeSpecialty
019.037227ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ala Dean Attar DMD PC Past Accepting new patients
Ala Dean Attar DMD PC Past Accepting new patients

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": "1783296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1205753639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 N SHERIDAN RD APT 1210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575947",
            "telephone_number": "440-309-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 FLORSHEIM DR STE 12",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485270",
            "telephone_number": "847-573-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVENGENCIE CHATWIN",
        "first_name": "FAITH",
        "middle_name": "LAUREN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-06",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.037227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; 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.