Organization Active NPI

Michael L Connolly DDS

  • Dental Clinic/Center
  • Chicago, IL
National Provider Identifier
1366969495
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019020342 Issued in IL
Legal business name
MICHAEL L CONNOLLY DDS
Practice address
6019 N Cicero Ave
Chicago, IL 60646-4301
Phone
(773) 286-9700
NPI assigned
Aug 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Authorized official

Name
Dr. Michael L Connolly, DDS
Title
Owner
Phone
(773) 286-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019020342 IL Primary

Addresses

Primary practice location

6019 N Cicero Ave
Chicago, IL 60646-4301

Mailing address

6019 N Cicero Ave
Chicago, IL 60646-4301
Phone (773) 286-9700

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1366969495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6019 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464301",
            "telephone_number": "773-286-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 N CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464301",
            "telephone_number": "773-286-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L CONNOLLY DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-286-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019020342",
            "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 Aug 29, 2017; 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.