Individual provider Active NPI

Erin Nicole Macko

  • Dentist
  • Chicago, IL
National Provider Identifier
1679883904
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
018.001780 Issued in IL
Practice address
600 N McClurg CT
Apt 4105a
Chicago, IL 60611-3044
Phone
(312) 926-6100
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 018.001780 IL Primary

Addresses

Primary practice location

600 N McClurg CT
Apt 4105a
Chicago, IL 60611-3044

Mailing address

600 N McClurg CT
Apt 4105a
Chicago, IL 60611-3044

Other names 1

  • Ms. Erin Nicole Kardine Former name

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
018.001780ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1679883904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MCCLURG CT",
            "address_2": "APT 4105A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MCCLURG CT",
            "address_2": "APT 4105A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113044",
            "telephone_number": "312-926-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKO",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "018.001780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "KARDINE",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.