Keith Sommers, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

21-001876 Issued in IL

Practice address

7603 North Ave
River Forest, IL 60305-1133

Phone

(708) 456-7787

Fax

(708) 689-0853

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Cameo Endodontics, LTD

  • Endodontics
  • River Forest, IL
  • NPI 1700959723
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1568410819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7603 NORTH AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051133",
            "telephone_number": "708-456-7787",
            "fax_number": "708-689-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7603 NORTH AVE",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051133",
            "telephone_number": "708-456-7787",
            "fax_number": "708-689-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERS",
        "first_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "21-001876",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19-024288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Ranae Skare, PT, MPT
• Ernest Lee Smith III, H.I.S.
• Maggie Smith
• Shanicka Smith, APRN
• Emily Gallagher Smythe, D.D.S.
• Stephen Edward Soppet, DDS
• Maureen L Spielman, M.A.,CCC-SLP
• Spine Rehabilitation and Wellness Inc
• Robert Ira Steinberg, DPM
• Step Into Clarity

• Endodontics in River Forest, IL
• Providers in River Forest, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.