Proverbs 3 PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019022143 Issued in IL

Legal business name

PROVERBS 3 PC

Practice address

2447 W 79TH St
Chicago, IL 60652-1734

Phone

(773) 776-1285

Fax

(773) 776-3171

NPI assigned

Oct 15, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Patricia James

Title

President

Phone

(773) 776-1285

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• That's The Tooth Doing business as

Tax ID family

Proverbs 3 PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Proverbs 3 PC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1649344755
  NPD tax ID

Locations

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

{
    "created_epoch": "1129334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1396734026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20568",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606200568",
            "telephone_number": "773-776-1285",
            "fax_number": "773-776-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 W 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606521734",
            "telephone_number": "773-776-1285",
            "fax_number": "773-776-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVERBS 3 PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-15",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-776-1285",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002342",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "That's The Tooth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marvin Craig Protasio, PHARMD
• Desiree Michelle Provax, APN
• Proven Behavioral Health
• Deborah Provenzano, SLPA
• John Marc Provenzano, CRNA
• Proverbs 3 PC
• Tim S. Provias, M.D.
• Providence Center
• Providence Homecare Services Inc
• Provident Hospital of Cook County

• All providers in Chicago, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.