Active NPI
Connor Steven Schroyer, DMD
- Dentist
- Western Springs, IL
National Provider Identifier
1558047878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019034377
- Practice address
- 4365 Lawn Avenue
Suite 3
Western Springs, IL 60558 - Phone
- (708) 246-4320
- NPI assigned
- Jun 22, 2023
- 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 | 019034377 | IL | Primary |
Addresses
Primary practice location
4365 Lawn Avenue
Suite 3
Western Springs, IL 60558
Mailing address
110 Woodstock Ave
Clarendon Hills, IL 60514-1133
Phone (630) 939-9404
Other practice location 1
3216 Kenilworth Ave
Berwyn, IL 60402-3003
Phone (708) 749-4080
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 |
|---|---|---|---|
| 019034377 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1558047878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 WOODSTOCK AVE",
"city": "CLARENDON HILLS",
"state": "IL",
"postal_code": "605141133",
"telephone_number": "630-939-9404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4365 LAWN AVENUE",
"address_2": "SUITE 3",
"city": "WESTERN SPRINGS",
"state": "IL",
"postal_code": "60558",
"telephone_number": "708-246-4320"
}
],
"practiceLocations": [
{
"address_1": "3216 Kenilworth Ave",
"address_purpose": "LOCATION",
"city": "Berwyn",
"state": "IL",
"postal_code": "604023003",
"country_code": "US",
"telephone_number": "708-749-4080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCHROYER",
"first_name": "CONNOR",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-22",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019034377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Western Springs, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.