Individual provider Active NPI

Lisa Maire McKee, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Downers Grove, IL
National Provider Identifier
1659527539
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
019019829 Issued in IL
Practice address
6224 Main St
C
Downers Grove, IL 60516-1900
Phone
(630) 963-1458
Fax
(630) 963-5510
NPI assigned
Aug 12, 2008
Last updated
Aug 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019019829 IL Primary

Addresses

Primary practice location

6224 Main St
C
Downers Grove, IL 60516-1900

Mailing address

6224 S. Main Street
C
Downers Grove, IL 60516-1986
Phone (630) 963-1458

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
I20150826000524 IL Order and Referring Only - DentistPractitioner - Dentist 3779899489

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1659527539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6224 S. MAIN STREET",
            "address_2": "C",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605161986",
            "telephone_number": "630-963-1458",
            "fax_number": "630-963-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6224 MAIN ST",
            "address_2": "C",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605161900",
            "telephone_number": "630-963-1458",
            "fax_number": "630-963-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "LISA",
        "middle_name": "MAIRE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019019829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.