Individual provider Active NPI

Karen Homsi, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Park Ridge, IL
National Provider Identifier
1508597543
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
021003178 Issued in IL
Practice address
401 W Talcott Rd
Park Ridge, IL 60068-5408
Phone
(847) 318-7711
NPI assigned
Jun 21, 2022
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019032339 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019032339 IL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 021003178 IL Primary

Addresses

Primary practice location

401 W Talcott Rd
Park Ridge, IL 60068-5408

Mailing address

921 S Bishop St Apt 2
Chicago, IL 60607-3895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019032339ILMDDentist
021003178ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
South Park Ortho PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Jun 26, 2022 Accepting new patients

Locations

401 W Talcott Rd
Park Ridge, IL 60068
Phone (847) 318-7711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1508597543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 S BISHOP ST APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W TALCOTT RD",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600685408",
            "telephone_number": "847-318-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMSI",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032339",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019032339",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021003178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.