Michael P. McCafferty, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019020122 Issued in IL

Practice address

7777 Lake St
Suite 108
River Forest, IL 60305-1734

Phone

(708) 366-7840

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366595795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 LAKE ST",
            "address_2": "SUITE 108",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051734",
            "telephone_number": "708-366-7840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 LAKE ST",
            "address_2": "SUITE 108",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051734",
            "telephone_number": "708-366-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFERTY",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary L. Kelly, D.O., S.C.
• George Robert Mason, M.D.
• Pearly Mathew, SLP
• Meghan Matz, WHNP
• Colleen McAdams, OTR
• Raymond J McDonald, MD
• Corey Ann McGrath, PT
• Sean McInerney
• Teresa McKenzie, MD
• Jill Christine McMahon, D.M.D

• General Practice Dentistry in River Forest, IL
• Providers in River Forest, IL by specialty
• General Practice Dentistry in Illinois

• 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.

Verify at the official NPI Registry.