Individual provider Active NPI

William E. McNerney, D.D.S.

  • General Practice Dentistry
  • Crystal Lake, IL
National Provider Identifier
1235205550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
300 Memorial Dr Ste 400
Crystal Lake, IL 60014-6273
Phone
(815) 459-8127
Fax
(815) 459-8427
NPI assigned
Nov 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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

300 Memorial Dr Ste 400
Crystal Lake, IL 60014-6273

Mailing address

300 Memorial Dr Ste 400
Crystal Lake, IL 60014-6273
Phone (815) 459-8127

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150417000972 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7719205038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-019557ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Office 300 Memorial Drive LLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235205550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEMORIAL DR STE 400",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146273",
            "telephone_number": "815-459-8127",
            "fax_number": "815-459-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEMORIAL DR STE 400",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146273",
            "telephone_number": "815-459-8127",
            "fax_number": "815-459-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNERNEY",
        "first_name": "WILLIAM",
        "middle_name": "E.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.