Active NPI
Carol J McNeely, D.D.S.
- Dentist
- Chicago, IL
National Provider Identifier
1285861922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.016826
- Practice address
- 4800 S Lake Park Ave Apt 1707
Chicago, IL 60615-2024 - Phone
- (773) 285-5880
- Fax
- (773) 285-5880
- NPI assigned
- Jun 21, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.016826 | IL | Primary |
Addresses
Primary practice location
4800 S Lake Park Ave Apt 1707
Chicago, IL 60615-2024
Mailing address
4800 S Lake Park Ave Apt 1707
Chicago, IL 60615-2024
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019.016826 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245542400000",
"number": "1285861922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 S LAKE PARK AVE APT 1707",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606152024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 S LAKE PARK AVE APT 1707",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606152024",
"telephone_number": "773-285-5880",
"fax_number": "773-285-5880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNEELY",
"first_name": "CAROL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-21",
"last_updated": "2009-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.016826",
"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 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.