Active NPI
Steven D Pooley, DDS
- General Practice Dentistry
- Loves Park, IL
National Provider Identifier
1326119280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Practice address
- 7318 N Alpine Rd
Loves Park, IL 61111-3902 - Phone
- (815) 968-5434
- Fax
- (815) 968-5475
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Primary |
Addresses
Primary practice location
7318 N Alpine Rd
Loves Park, IL 61111-3902
Mailing address
7318 N Alpine Rd
Loves Park, IL 61111-3902
Phone (815) 968-5434
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150415002000 | IL | Order and Referring Only - Dentist | 1052639473 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019020588 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326119280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7318 N ALPINE RD",
"city": "LOVES PARK",
"state": "IL",
"postal_code": "611113902",
"telephone_number": "815-968-5434",
"fax_number": "815-968-5475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7318 N ALPINE RD",
"city": "LOVES PARK",
"state": "IL",
"postal_code": "611113902",
"telephone_number": "815-968-5434",
"fax_number": "815-968-5475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLEY",
"first_name": "STEVEN",
"middle_name": "D",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"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 Loves Park, IL
- Asher Jr Timario Piedad, MD
- Joseph John Pingo, BCBA
- Karen G. Platzbecker, LPC
- Wieslaw J. Podlasek, M.D.
- Pointcore, Inc.
- Drew Alexander Potter, ATC, LAT
- Premier Medical Rehabilitation SC
- Rebeca Frances Pritchard, MSN, APRN, FNP-BC
- Professional Medical Staffing Corp.
- Progressive Chiropractic Wellness & Rehab Centre, P.C.
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.