Active NPI
Anthea Marie McCormick, DMD
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1578083457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019031200
- Practice address
- 25 E Washington St Ste 1707
Chicago, IL 60602-1806 - Phone
- (312) 429-7425
- NPI assigned
- Jun 22, 2017
- 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 | 019031200 | IL | Primary |
Addresses
Primary practice location
25 E Washington St Ste 1707
Chicago, IL 60602-1806
Mailing address
17W726 Butterfield Rd Apt 306
Oakbrook Terrace, IL 60181-4230
Phone (574) 850-1557
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 461088803 | Other | IL | MILLENNIUM PARK SMILES LLC |
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 |
|---|---|---|---|
| 019031200 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498089600000",
"number": "1578083457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17W726 BUTTERFIELD RD APT 306",
"city": "OAKBROOK TERRACE",
"state": "IL",
"postal_code": "601814230",
"telephone_number": "574-850-1557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 E WASHINGTON ST STE 1707",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021806",
"telephone_number": "312-429-7425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "ANTHEA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-22",
"last_updated": "2017-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019031200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MILLENNIUM PARK SMILES LLC",
"identifier": "461088803",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.