NPIMap

Organization Active NPI

Fred J. Marchese DDS, LTD

  • Dental Clinic/Center
  • Melrose Park, IL
National Provider Identifier
1497025324
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019019113 Issued in IL
Legal business name
FRED J. MARCHESE DDS, LTD
Practice address
1440 W North Ave
Suite 304
Melrose Park, IL 60160-1422
Phone
(708) 343-6065
Fax
(708) 343-6287
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Dr. Fred J. Marchese, D.D.S.NPI 1033139993
Title
Owner
Phone
(708) 343-6065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019019113 IL Primary

Addresses

Primary practice location

1440 W North Ave
Suite 304
Melrose Park, IL 60160-1422

Mailing address

1440 W North Ave
Suite 304
Melrose Park, IL 60160-1422
Phone (708) 343-6065

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.

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1497025324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W NORTH AVE",
            "address_2": "SUITE 304",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601422",
            "telephone_number": "708-343-6065",
            "fax_number": "708-343-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 W NORTH AVE",
            "address_2": "SUITE 304",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601422",
            "telephone_number": "708-343-6065",
            "fax_number": "708-343-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED J. MARCHESE DDS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "MARCHESE",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-343-6065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019019113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.