Individual provider Active NPI

Erin Kathleen Nicorata, D.D.S.

  • Dentist
  • Palos Heights, IL
National Provider Identifier
1407297906
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019029530 Issued in IL
Practice address
6741 W 127TH St
Palos Heights, IL 60463-2253
Phone
(708) 448-1125
Fax
(708) 448-1730
NPI assigned
Jul 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019029530 IL Primary

Addresses

Primary practice location

6741 W 127TH St
Palos Heights, IL 60463-2253

Mailing address

6741 W 127TH St
Palos Heights, IL 60463-2253
Phone (708) 448-1125

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
I20160202002360 IL Order and Referring Only - DentistPractitioner - Dentist 7911201561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019029530ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven J. Nicorata, D.D.S., P.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1407297906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6741 W 127TH ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632253",
            "telephone_number": "708-448-1125",
            "fax_number": "708-448-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6741 W 127TH ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632253",
            "telephone_number": "708-448-1125",
            "fax_number": "708-448-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICORATA",
        "first_name": "ERIN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.