Individual provider Active NPI

Scott Hocker, DDS

  • Dentist
  • Great Lakes, IL
National Provider Identifier
1508012279
Registry record updated Aug 14, 2008
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12011186A Issued in IN
Practice address
3001A Sixth St
BLDG. 1017 Uss Osborne
Great Lakes, IL 60088
Phone
(847) 688-2100
NPI assigned
Aug 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011186A IN Primary

Addresses

Primary practice location

3001A Sixth St
BLDG. 1017 Uss Osborne
Great Lakes, IL 60088

Mailing address

1379 Western Ave
Apt. 2D
Lake Forest, IL 60045

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
I20130528000499 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012155310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1508012279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1379 WESTERN AVE",
            "address_2": "APT. 2D",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "60045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001A SIXTH ST",
            "address_2": "BLDG. 1017 USS OSBORNE",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "60088",
            "telephone_number": "847-688-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCKER",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011186A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

Verify at the official NPI Registry.