Active NPI
Delora Eileen Gerhardt, RDH
- Dental Hygienist
- Wonder Lake, IL
National Provider Identifier
1649324146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- Practice address
- 7424 Hancock Dr
Wonder Lake, IL 60097-9217 - Phone
- (815) 653-5141
- Fax
- (815) 653-3191
- NPI assigned
- Jan 22, 2007
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | IL | Primary |
Addresses
Primary practice location
7424 Hancock Dr
Wonder Lake, IL 60097-9217
Mailing address
PO Box 172
Wonder Lake, IL 60097-0172
Phone (815) 653-9573
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 |
|---|---|---|---|
| 020-002934 | IL | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James J Schroeder, DDS LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Wonder Lake, IL
- NPI 1932252392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649324146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 172",
"city": "WONDER LAKE",
"state": "IL",
"postal_code": "600970172",
"telephone_number": "815-653-9573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7424 HANCOCK DR",
"city": "WONDER LAKE",
"state": "IL",
"postal_code": "600979217",
"telephone_number": "815-653-5141",
"fax_number": "815-653-3191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERHARDT",
"first_name": "DELORA",
"middle_name": "EILEEN",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wonder Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.