Active NPI
Karen Renaee Nash, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1417982687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019019
- Practice address
- 1111 E 87TH St
Ste 100
Chicago, IL 60619 - Phone
- (773) 375-3759
- Fax
- (773) 375-5745
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0210012900 | IL | |
| Dentist | 122300000X | 019019 | IL | Primary |
Addresses
Primary practice location
1111 E 87TH St
Ste 100
Chicago, IL 60619
Mailing address
6858 S Euclid
Chicago, IL 60649
Phone (773) 493-6687
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019019 | IL | MD | Dentist |
| 0210012900 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417982687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6858 S EUCLID",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60649",
"telephone_number": "773-493-6687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 E 87TH ST",
"address_2": "STE 100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60619",
"telephone_number": "773-375-3759",
"fax_number": "773-375-5745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH",
"first_name": "KAREN",
"middle_name": "RENAEE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "0210012900",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.