NPIMap

Organization Active NPI

Stewart G Willoughby DDS PC

  • Dentist
  • Chicago, IL
National Provider Identifier
1427122274
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
STEWART G WILLOUGHBY DDS PC
Practice address
8301 S Brandon Ave
Chicago, IL 60617-2656
Phone
(773) 375-6199
NPI assigned
Nov 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stewart Gordon Willoughby, DDS LDS RCS MSNPI 1659424232
Title
President
Phone
(773) 375-6199

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X IL Primary

Addresses

Primary practice location

8301 S Brandon Ave
Chicago, IL 60617-2656

Mailing address

8301 S Brandon Ave
Chicago, IL 60617-2656
Phone (773) 375-6199

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427122274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 S BRANDON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172656",
            "telephone_number": "773-375-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 S BRANDON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606172656",
            "telephone_number": "773-375-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWART G WILLOUGHBY DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLOUGHBY",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-375-6199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS LDS RCS MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "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 Aug 22, 2020; 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.