Park Ridge Endodontics

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

060009606 Issued in IL

Legal business name

PARK RIDGE ENDODONTICS

Practice address

350 S Northwest Hwy
Suite 116
Park Ridge, IL 60068-4216

Phone

(847) 823-4161

Fax

(847) 823-4163

NPI assigned

Feb 16, 2010

Last updated

Feb 16, 2010By 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

Dr. Patrick I Fitzgerald, DDSNPI 1730243213

Title

President

Phone

(847) 823-4161

Specialties & licenses 2

Addresses

Locations

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.

• Patrick Ian Fitzgerald, DDS

  • Endodontics
  • Park Ridge, IL
  • NPI 1730243213
  Authorized official Same address or phone

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1467774661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY",
            "address_2": "SUITE 116",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684216",
            "telephone_number": "847-823-4161",
            "fax_number": "847-823-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY",
            "address_2": "SUITE 116",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684216",
            "telephone_number": "847-823-4161",
            "fax_number": "847-823-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-823-4161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IL",
            "license": "060009606",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "IL",
            "license": "060009606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Park Ridge Chiropractic
• Park Ridge Complete Dental PLLC
• Park Ridge Counseling LLC
• Park Ridge Dental Associates
• Park Ridge Dentistry PLLC
• Park Ridge Healthcare Center LLC (Park Ridge Healthcare Center)
• Park Ridge Healthcare Center LLC (Park Ridge Healthcare Center)
• Park Ridge Lab Inc
• Park Ridge Multi-Med, S.C.
• Park Ridge North Suburban Vision Consultants LLC (North Suburban Vision Consultants-Park Ridge)

• Preferred Provider Organization in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.