Active NPI
Timothy R Toepke
- General Practice Dentistry
- Downers Grove, IL
National Provider Identifier
1376627471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019-017781
- Practice address
- 3450 Lacey Rd
Downers Grove, IL 60515-5430 - Phone
- (630) 743-4500
- Fax
- (630) 743-4613
- NPI assigned
- Oct 25, 2006
- Last updated
- May 29, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 019-017781 | IL | Primary |
Addresses
Primary practice location
3450 Lacey Rd
Downers Grove, IL 60515-5430
Mailing address
3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone (630) 743-4500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 3, 2019 through Jun 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-017781 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of the University of Illinois | General Practice | Past | Accepting new patients |
Interoperability endpoints
- ttoepke18588@direct.midwestern.edu
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1376627471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 LACEY RD",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155430",
"telephone_number": "630-743-4500",
"fax_number": "630-743-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 LACEY RD",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155430",
"telephone_number": "630-743-4500",
"fax_number": "630-743-4613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOEPKE",
"first_name": "TIMOTHY",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019-017781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.