Individual provider Active NPI

Sidra Kader, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1649952995
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019034559 Issued in IL
Practice address
2101 E 71St St
Chicago, IL 60649-2143
Phone
(773) 241-7000
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019034559 IL Primary

Addresses

Primary practice location

2101 E 71St St
Chicago, IL 60649-2143

Mailing address

2101 E 71St St
Chicago, IL 60649-2143

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240212002353 IL Order and Referring Only - DentistPractitioner - Dentist 4789027228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1649952995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E 71ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 E 71ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492143",
            "telephone_number": "773-241-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADER",
        "first_name": "SIDRA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019034559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.