Individual provider Active NPI

Duane Eugene Wolff, D.D.S.

  • General Practice Dentistry
  • Homewood, IL
National Provider Identifier
1659463438
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
18161 Morris Ave
Suite 107
Homewood, IL 60430-2108
Phone
(708) 799-7722
Fax
(708) 799-7748
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

18161 Morris Ave
Suite 107
Homewood, IL 60430-2108

Mailing address

18161 Morris Ave
Suite 107
Homewood, IL 60430-2108
Phone (708) 799-7722

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
I20150126002275 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6800110644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duane E. Wolff, D.D.S., P.C. 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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659463438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18161 MORRIS AVE",
            "address_2": "SUITE 107",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302108",
            "telephone_number": "708-799-7722",
            "fax_number": "708-799-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18161 MORRIS AVE",
            "address_2": "SUITE 107",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302108",
            "telephone_number": "708-799-7722",
            "fax_number": "708-799-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "DUANE",
        "middle_name": "EUGENE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.