NPIMap

Organization Active NPI

Toni Ellis Wolf, DDS, PC

  • Dentist
  • Skokie, IL
National Provider Identifier
1679980924
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019016875 Issued in IL
Legal business name
TONI ELLIS WOLF, DDS, PC
Practice address
4905 Old Orchard Ctr
Su 232
Skokie, IL 60077-1458
Phone
(847) 673-2052
Fax
(847) 673-5002
NPI assigned
Jul 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Dr. Toni Ellis Wolf, DDS
Title
President
Phone
(847) 673-2052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019016875 IL Primary

Addresses

Primary practice location

4905 Old Orchard Ctr
Su 232
Skokie, IL 60077-1458

Mailing address

4905 Old Orchard Ctr
Su 232
Skokie, IL 60077-1458
Phone (847) 673-2052

Other names 1

  • Old Orchard Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Old Orchard Smiles2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1679980924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR",
            "address_2": "SU 232",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771458",
            "telephone_number": "847-673-2052",
            "fax_number": "847-673-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 OLD ORCHARD CTR",
            "address_2": "SU 232",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771458",
            "telephone_number": "847-673-2052",
            "fax_number": "847-673-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONI ELLIS WOLF, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-18",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "WOLF",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "ELLIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-673-2052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019016875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Orchard Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; 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.