Individual provider Active NPI

Susan Kochlefl, DDS

  • Dentist
  • Oak Brook, IL
National Provider Identifier
1356596548
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19-21678 Issued in IL
Practice address
120 Oakbrook Ctr
Suite 514
Oak Brook, IL 60523-1806
Phone
(630) 573-9573
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19-21678 IL Primary

Addresses

Primary practice location

120 Oakbrook Ctr
Suite 514
Oak Brook, IL 60523-1806

Mailing address

120 Oakbrook Ctr
Suite 514
Oak Brook, IL 60523-1806

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
19-21678ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1356596548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 OAKBROOK CTR",
            "address_2": "SUITE 514",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OAKBROOK CTR",
            "address_2": "SUITE 514",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231806",
            "telephone_number": "630-573-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHLEFL",
        "first_name": "SUSAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19-21678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.