Abraham Philip, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

025107 Issued in IL

Practice address

100 W Roosevelt Rd Ste B5-204
Wheaton, IL 60187-5247

Phone

(630) 340-0781

NPI assigned

Mar 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1578692935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W ROOSEVELT RD STE B5-204",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875247",
            "telephone_number": "630-340-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W ROOSEVELT RD STE B5-204",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601875247",
            "telephone_number": "630-340-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "025107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana M Peters, RD, LD
• Rilea Joy Petersen, LPC
• Colette L Petit, RN
• Casey Frances Petterson, MS, RN
• Elaine Pfaff
• Mathew Suresh Philip, M.D.
• Jane Phillip
• Bradley M Phillips, PHARMD
• Henry Daniel Phillips, LCPC, CADC
• Kenneth P. Phillips, M.D.

• General Practice Dentistry in Wheaton, IL
• Providers in Wheaton, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.