Susan Erdman-Spain, DDS, MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019023725 Issued in IL

Practice address

200 Milwaukee Ave
Otragen Orthodontics PC
Buffalo Grove, IL 60089-2812

Phone

(847) 520-0770

Fax

(847) 520-1179

NPI assigned

Dec 6, 2010

Sex

Female

Sole proprietor

Yes

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: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Beyer Dental LTD

  • Endodontics
  • Buffalo Grove, IL
  • NPI 1609922137

  General Practice

  NPD (past)
• Nextgen Endodontics LTD

  • Endodontics
  • Buffalo Grove, IL
  • NPI 1295013290
  NPD (past)

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1639472111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILWAUKEE AVE",
            "address_2": "OTRAGEN ORTHODONTICS PC",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892812",
            "telephone_number": "847-520-0770",
            "fax_number": "847-520-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MILWAUKEE AVE",
            "address_2": "OTRAGEN ORTHODONTICS PC",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892812",
            "telephone_number": "847-520-0770",
            "fax_number": "847-520-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMAN-SPAIN",
        "first_name": "SUSAN",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019023725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliot M Razdolsky DDS Inc
• Anthony P Eltink, D.D.S., M.S.
• Rebekah E Enfinger, P.T., D.P.T.
• Epic Health L.L.C. Dba Epic Health
• Robert Irwin Epstein, DPM
• David Eremkine
• Eric N. Smith, D.C., P.C.
• Sky Espe
• Nancy Esterkin, APRN
• Maria Estrada, BSW

• General Practice Dentistry in Buffalo Grove, IL
• Providers in Buffalo Grove, 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 Dec 6, 2010; 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.