Individual provider Active NPI

F.Robert Wilkin, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1558628305
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019017750 Issued in IL
Practice address
4801 W Peterson Ave
614
Chicago, IL 60646-5713
Phone
(773) 769-6088
NPI assigned
Apr 18, 2012
Last updated
Dec 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019017750 IL Primary

Addresses

Primary practice location

4801 W Peterson Ave
614
Chicago, IL 60646-5713

Mailing address

4801 W Peterson Ave
614
Chicago, IL 60646-5713
Phone (773) 769-6088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813009881 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2860707312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019017750ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
F. Robert Wilkin D.D.S., LTD 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, 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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1558628305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "614",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465713",
            "telephone_number": "773-769-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "614",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465713",
            "telephone_number": "773-769-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIN",
        "first_name": "F.ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019017750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.