Active NPI
Tami L Zuck, D.D.S.
- General Practice Dentistry
- Crystal Lake, IL
National Provider Identifier
1508909573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Practice address
- 360 N Terra Cotta Rd
Suite #D
Crystal Lake, IL 60012-3749 - Phone
- (815) 477-0770
- Fax
- (815) 444-8841
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Primary |
Addresses
Primary practice location
360 N Terra Cotta Rd
Suite #D
Crystal Lake, IL 60012-3749
Mailing address
670 Wyngate LN
Buffalo Grove, IL 60089-1445
Phone (847) 215-9018
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019025328 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Valley Dental Associates of Crystal Lake LLC | General Practice | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Crystal Lake, IL
- NPI 1972646925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508909573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 WYNGATE LN",
"city": "BUFFALO GROVE",
"state": "IL",
"postal_code": "600891445",
"telephone_number": "847-215-9018",
"fax_number": "815-444-8841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 N TERRA COTTA RD",
"address_2": "SUITE #D",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600123749",
"telephone_number": "815-477-0770",
"fax_number": "815-444-8841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUCK",
"first_name": "TAMI",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.