Active NPI
Kevin D. McClure, DDS
- General Practice Dentistry
- North Riverside, IL
National Provider Identifier
1356322929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019-025535
- Practice address
- 7301 W 25TH St
#127
North Riverside, IL 60546-1409 - Phone
- (708) 732-1997
- NPI assigned
- Nov 9, 2005
- 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 | 019-025535 | IL | Primary |
Addresses
Primary practice location
7301 W 25TH St
#127
North Riverside, IL 60546-1409
Mailing address
7301 W 25TH St
#127
North Riverside, IL 60546-1409
Phone (708) 732-1997
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 |
|---|---|---|---|
| 019-025535 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253404800000",
"number": "1356322929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 W 25TH ST",
"address_2": "#127",
"city": "NORTH RIVERSIDE",
"state": "IL",
"postal_code": "605461409",
"telephone_number": "708-732-1997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7301 W 25TH ST",
"address_2": "#127",
"city": "NORTH RIVERSIDE",
"state": "IL",
"postal_code": "605461409",
"telephone_number": "708-732-1997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLURE",
"first_name": "KEVIN",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2009-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-025535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Riverside, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.