Individual provider Active NPI

Vincent Anthony Romanelli

  • Dentist
  • Algonquin, IL
National Provider Identifier
1437465440
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019017087 Issued in IL
Practice address
2401 Harnish Dr
2401 Harnish Dr.
Algonquin, IL 60102-6846
Phone
(847) 458-7122
NPI assigned
Aug 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019017087 IL Primary

Addresses

Primary practice location

2401 Harnish Dr
2401 Harnish Dr.
Algonquin, IL 60102-6846

Mailing address

2401 Harnish Dr
Algonquin, IL 60102-6846
Phone (847) 458-7122

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
I20160219000277 IL Order and Referring Only - DentistPractitioner - Dentist 9234434846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019017087ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1437465440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 HARNISH DR",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601026846",
            "telephone_number": "847-458-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 HARNISH DR",
            "address_2": "2401 HARNISH DR.",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601026846",
            "telephone_number": "847-458-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANELLI",
        "first_name": "VINCENT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019017087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.