Individual provider Active NPI

Steffy Macwan-Christian

  • General Practice Dentistry
  • Oak Park, IL
National Provider Identifier
1649908948
Registry record updated Aug 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.033655 Issued in IL
Practice address
1010 Lake St
Oak Park, IL 60301-1147
Phone
(708) 848-6822
NPI assigned
Aug 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 019.033655 IL Primary

Addresses

Primary practice location

1010 Lake St
Oak Park, IL 60301-1147

Mailing address

2443 N Western Ave Apt 302
Chicago, IL 60647-0976
Phone (773) 710-6258

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

LicenseStateTypeSpecialty
019.033655ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1660348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660348800000",
    "number": "1649908948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 N WESTERN AVE APT 302",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606470976",
            "telephone_number": "773-710-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011147",
            "telephone_number": "708-848-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACWAN-CHRISTIAN",
        "first_name": "STEFFY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-13",
        "last_updated": "2022-08-13",
        "certification_date": "2022-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.