Mark J. Holzer, DDS, RPH

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-021131 Issued in IL

Practice address

241 Golf Mill Ctr
Suite 812
Niles, IL 60714-1224

Phone

(847) 298-5885

Fax

(847) 298-2938

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. M. J. Holzer Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1396893764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 ROBINWOOD LN",
            "city": "RIVERWOODS",
            "state": "IL",
            "postal_code": "600151412",
            "telephone_number": "847-940-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 GOLF MILL CTR",
            "address_2": "SUITE 812",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141224",
            "telephone_number": "847-298-5885",
            "fax_number": "847-298-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZER",
        "first_name": "MARK",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS, RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-021131",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-039887",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M.",
            "last_name": "HOLZER",
            "middle_name": "J.",
            "prefix": "DR.",
            "credential": "DDS, RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Diana Heskin
• Highland Park CVS LLC
• Highland Park CVS LLC
• Highland Park CVS, L.L.C.
• Highland Park CVS, L.L.C.
• Home Physicians of Illinois LLC
• Homehealth of America, Inc.
• Homeland Homehealth Provider, Inc,
• Housecall Health Group Inc
• Matthew James Howard

• General Practice Dentistry in Niles, IL
• Providers in Niles, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.