Active NPI
Headache Center of Chicago
- Dentist
- Westmont, IL
National Provider Identifier
1508269358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019021165
- Legal business name
- HEADACHE CENTER OF CHICAGO
- Practice address
- 6317 Fairview Ave
Ste 3
Westmont, IL 60559-2887 - Phone
- (630) 852-6666
- Fax
- (630) 968-0958
- NPI assigned
- Oct 7, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Thomas William Brzostowski, DDS
- Title
- President
- Phone
- (630) 852-6666
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019021165 | IL | Primary |
| Dentist | 122300000X | 019025308 | WI |
Addresses
Primary practice location
6317 Fairview Ave
Ste 3
Westmont, IL 60559-2887
Mailing address
6317 Fairview Ave
Ste 3
Westmont, IL 60559-2887
Phone (630) 852-6666
National Provider Directory
National Provider DirectoryLocations
6317 Fairview Ave
Ste 3
Westmont, IL 60559
Phone (630) 852-6666
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Westmont, IL
- NPI 1497873962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1412640000000",
"number": "1508269358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6317 FAIRVIEW AVE",
"address_2": "STE 3",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605592887",
"telephone_number": "630-852-6666",
"fax_number": "630-968-0958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6317 FAIRVIEW AVE",
"address_2": "STE 3",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605592887",
"telephone_number": "630-852-6666",
"fax_number": "630-968-0958"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEADACHE CENTER OF CHICAGO",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-07",
"last_updated": "2014-10-07",
"status": "A",
"authorized_official_last_name": "BRZOSTOWSKI",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "630-852-6666",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "IL",
"license": "019021165",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "WI",
"license": "019025308",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Westmont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.