Active NPI
Charles Richard Neach, DDS
- Endodontics
- Chicago, IL
National Provider Identifier
1629453378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 019.014642
- Practice address
- 801 S Paulina St RM 302a
Chicago, IL 60612-7210 - Phone
- (312) 996-7514
- Fax
- (312) 996-3375
- NPI assigned
- Jul 23, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 019.014642 | IL | Primary |
Addresses
Primary practice location
801 S Paulina St RM 302a
Chicago, IL 60612-7210
Mailing address
801 S Paulina St RM 302a
Chicago, IL 60612-7210
Phone (312) 996-7514
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 |
|---|---|---|---|
| 019.014642 | IL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593043200000",
"number": "1629453378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 S PAULINA ST RM 302A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "312-996-7514",
"fax_number": "312-996-3375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 S PAULINA ST RM 302A",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127210",
"telephone_number": "312-996-7514",
"fax_number": "312-996-3375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEACH",
"first_name": "CHARLES",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-23",
"last_updated": "2020-06-25",
"certification_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "IL",
"license": "019.014642",
"primary": true
}
],
"identifiers": [],
"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 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.