Individual provider Active NPI

Patricia Casey

  • Pediatric Dentistry
  • Arlington Heights, IL
National Provider Identifier
1396173480
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
021003080 Issued in IL
Practice address
201 N Arlington Heights Rd Ste 200
Arlington Heights, IL 60004-6059
Phone
(847) 906-8692
NPI assigned
Oct 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 021003080 IL Primary
General Practice Dentistry 1223G0001X 019029623 IL

Addresses

Primary practice location

201 N Arlington Heights Rd Ste 200
Arlington Heights, IL 60004-6059

Mailing address

4917 W 105TH PL
Oak Lawn, IL 60453-5230
Phone (708) 263-5250

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160224000619 IL Practitioner - Oral Surgery 3274838529 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019029623ILMDGeneral Practice Dentistry
021003080ILMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc. CurrentSince Jan 24, 2016 Accepting new patients
Erie Family Health Center Inc CurrentSince Jan 24, 2016 Accepting new patients
Amit Sud DDS @ Anita Verma DDS General Practice PastSince Sep 1, 2020 Accepting new patients

Locations

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1504 S Albany Ave
Chicago, IL 60623

2750 W North Ave
Chicago, IL 60647
Phone (312) 432-2767

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1396173480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 W 105TH PL",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535230",
            "telephone_number": "708-263-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N ARLINGTON HEIGHTS RD STE 200",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600046059",
            "telephone_number": "847-906-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "021003080",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019029623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.