Raymond Joseph Adamczyk, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

834 E Rand Road
Unit 3
Mount Prospect, IL 60056-2569

Phone

(847) 368-0868

Fax

(847) 368-0868

NPI assigned

Dec 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689733800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 E RAND RD",
            "address_2": "UNIT 3",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562569",
            "telephone_number": "847-368-0868",
            "fax_number": "847-368-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 E RAND ROAD",
            "address_2": "UNIT 3",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600562569",
            "telephone_number": "847-368-0868",
            "fax_number": "847-368-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMCZYK",
        "first_name": "RAYMOND",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "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": []
}

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• General Practice Dentistry in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.