Boys & Girls Club of Chicago - Robert R. McCormick Boys & Girls Club

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BOYS & GIRLS CLUB OF CHICAGO - ROBERT R. MCCORMICK BOYS & GIRLS CLUB

Practice address

4835 N Sheridan Rd
Chicago, IL 60640-3718

Phone

(773) 271-8400

Fax

(773) 271-2425

NPI assigned

Jan 24, 2008

Last updated

Jan 24, 2008By 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

George Colone

Title

Club Director

Phone

(773) 271-8400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1417134131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4835 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403718",
            "telephone_number": "773-271-8400",
            "fax_number": "773-271-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4835 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606403718",
            "telephone_number": "773-271-8400",
            "fax_number": "773-271-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS & GIRLS CLUB OF CHICAGO - ROBERT R. MCCORMICK BOYS & GIRLS CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "COLONE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CLUB DIRECTOR",
        "authorized_official_telephone_number": "773-271-8400"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Boyle, DMD
• Patrick Boyle, DO
• Stephanie Boyle
• Kathleen Lynn Boyne, M.D.
• Kara Boynewicz, PT
• Mary Ellen Boyte, D.N.
• Christina M Bozarth, BS, IBCLC
• Stephen A. Bozek, M.D.
• Jenna Boznos, PHARMD
• Kenny Bozorgi, M.D.

• Pediatric Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.