Alex Dale Ehrlich, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007771A Issued in IN

Practice address

3001 6TH St
Professional Affairs Coordinator Naval Hospital
Great Lakes, IL 60088-2833

Phone

(847) 688-5647

Fax

(847) 688-4279

NPI assigned

Feb 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jan Kozlowski Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205808235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 6TH ST",
            "address_2": "PROFESSIONAL AFFAIRS COORDINATOR NAVAL HOSPITAL",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-5647",
            "fax_number": "847-688-4279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 6TH ST",
            "address_2": "PROFESSIONAL AFFAIRS COORDINATOR NAVAL HOSPITAL",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-5647",
            "fax_number": "847-688-4279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRLICH",
        "first_name": "ALEX",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007771A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAN",
            "last_name": "KOZLOWSKI",
            "prefix": "MRS.",
            "credential": "PAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Judy Ann Dixon, FNP
• Michael Shawn Donoghue, D.D.S.
• Jimi Michelle Doty, NP
• Adam Robert Dziedzic, P.A.-C
• Chris Ebert, IDC
• Theresa Paola Everest, WHNP
• Allison Fedler
• Michael Philip Fee, DDS
• Luis Victor Fernandez
• Timothy Paul Fitzharris, DDS

• General Practice Dentistry in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• General Practice Dentistry in Illinois

• 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.

Verify at the official NPI Registry.