Endodontists of Illinois

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

019028814 Issued in IL

Legal business name

ENDODONTISTS OF ILLINOIS

Practice address

113 N Regency Dr
Bloomington, IL 61701-3515

Phone

(309) 661-8900

NPI assigned

Apr 8, 2014

Last updated

Apr 8, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathaniel Blake Swaar, D.M.D.

Title

Vice President

Phone

(309) 661-8900

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith Allen Evans, D.M.D., M.S.

  • Endodontics
  • Bloomington, IL
  • NPI 1215009923
  NPD (past)

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1396164398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 N REGENCY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013515",
            "telephone_number": "309-661-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 N REGENCY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013515",
            "telephone_number": "309-661-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTISTS OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-08",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "SWAAR",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "309-661-8900",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "019028814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empower You Medical Staffing Agency LLC.
• Empowerme Medical Group, PC
• Empowerme NP, LLC
• Empowerme Rehabilitation Illinois, LLC
• Endodontic Specialists LLC
• Equanimity Anesthesia Services, Professional Corporation
• Edward Ericksen
• Brentin L Erickson
• Bettina Ervin-Rodgers
• Morgan Erwin, FAMILY NURSE PRACTIT

• Endodontics in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.