Individual provider Active NPI

Natolya Latrese Thomas, D.D.S

  • Dentist
  • Chicago, IL
National Provider Identifier
1477861680
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.028365 Issued in IL
Practice address
9718 S Halsted St
Chicago, IL 60628-1007
Phone
(773) 233-4100
NPI assigned
Sep 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.028365 IL Primary

Addresses

Primary practice location

9718 S Halsted St
Chicago, IL 60628-1007

Mailing address

9718 S Halsted St
Chicago, IL 60628-1007
Phone (773) 233-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230502002019 DC Practitioner - Dentist 6800251570
I20250704000411 IL Practitioner - Dentist 6800251570 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.028365ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Apr 27, 2025 Accepting new patients
Cook County CurrentSince Apr 27, 2025 Accepting new patients
Cook County Current Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1477861680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9718 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281007",
            "telephone_number": "773-233-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9718 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281007",
            "telephone_number": "773-233-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "NATOLYA",
        "middle_name": "LATRESE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-22",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.028365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.