NPIMap

Organization Active NPI

Farrell

  • General Practice Dentistry
  • Lockport, IL
National Provider Identifier
1659602902
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FARRELL
Practice address
16533 W 159TH St
Lockport, IL 60441-7900
Phone
(815) 836-3700
Fax
(815) 836-3701
NPI assigned
Jan 27, 2010
Organization subpart
Yes
Parent organization
TWO RIVERS DENTAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Sohail S Shafi
Title
Manager
Phone
(630) 842-3705

Specialties & licenses 1

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

Addresses

Primary practice location

16533 W 159TH St
Lockport, IL 60441-7900

Mailing address

1730 Park St Ste 106
Naperville, IL 60563-2609
Phone (815) 836-3700

National Provider Directory

National Provider Directory
Tax ID family
Simply Dental8 organizations share this tax ID, including this one
Part of
Simply Dental

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16533 W 159th St
Lockport, IL 60441
Phone (815) 836-3700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1659602902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 PARK ST STE 106",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605632609",
            "telephone_number": "815-836-3700",
            "fax_number": "815-836-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16533 W 159TH ST",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604417900",
            "telephone_number": "815-836-3700",
            "fax_number": "815-836-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARRELL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TWO RIVERS DENTAL PC",
        "enumeration_date": "2010-01-27",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "SHAFI",
        "authorized_official_first_name": "SOHAIL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "630-842-3705"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.