Organization Active NPI

Headache Center of Chicago

  • Dentist
  • Westmont, IL
National Provider Identifier
1508269358
Registry record updated Oct 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019021165 Issued in IL
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

Updated by the provider on Oct 7, 2014

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)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 019021165 IL Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.