Individual provider Active NPI

Alireza Nili, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1225477169
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-029405 Issued in IL
Practice address
2266 N Lincoln Ave
Chicago, IL 60614-7600
Phone
(773) 528-6485
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019-029405 IL Primary

Addresses

Primary practice location

2266 N Lincoln Ave
Chicago, IL 60614-7600

Mailing address

511 Wennes CT
Oak Brook, IL 60523-2727
Phone (630) 531-1188

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
019-029405ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1225477169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 WENNES CT",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232727",
            "telephone_number": "630-531-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147600",
            "telephone_number": "773-528-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILI",
        "first_name": "ALIREZA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-029405",
            "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 Jun 24, 2013; 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.