Individual provider Active NPI

Robert N. Bitter, D.M.D.

  • Periodontics
  • Alton, IL
National Provider Identifier
1487740494
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
021001111 Issued in IL
Practice address
2800 College Avenue
Alton, IL 62002-4700
Phone
(847) 924-7663
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 021001111 IL Primary

Addresses

Primary practice location

2800 College Avenue
Alton, IL 62002-4700

Mailing address

2800 College Avenue
Alton, IL 62002-4700
Phone (847) 924-7663

Other practice location 1

9933 Lawler Ave
Suite 450
Skokie, IL 60077-3703
Phone (847) 675-4867

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
I20130716000452 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8820238801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
021001111ILMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1487740494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVENUE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024700",
            "telephone_number": "847-924-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVENUE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024700",
            "telephone_number": "847-924-7663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9933 Lawler Ave",
            "address_2": "Suite 450",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600773703",
            "country_code": "US",
            "telephone_number": "847-675-4867",
            "fax_number": "847-763-7058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BITTER",
        "first_name": "ROBERT",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021001111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.