Individual provider Active NPI

Lourdes Terrado Anonuevo, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1225027634
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
3549 W Irving Park Rd
Chicago, IL 60618-3219
Phone
(773) 509-9682
Fax
(773) 509-9339
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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 IL Primary

Addresses

Primary practice location

3549 W Irving Park Rd
Chicago, IL 60618-3219

Mailing address

3549 W Irving Park Rd
Chicago, IL 60618-3219
Phone (773) 509-9682

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
019021581ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1225027634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3549 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183219",
            "telephone_number": "773-509-9682",
            "fax_number": "773-509-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3549 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183219",
            "telephone_number": "773-509-9682",
            "fax_number": "773-509-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANONUEVO",
        "first_name": "LOURDES",
        "middle_name": "TERRADO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "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 Dec 14, 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.