Active NPI
Scott Hocker, DDS
- Dentist
- Great Lakes, IL
National Provider Identifier
1508012279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12011186A
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130528000499 | IL | Order and Referring Only - 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.