Willis Abt Dental Practice

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WILLIS ABT DENTAL PRACTICE

Practice address

4709 Golf Road
Suite 1005 2 Concourse Office Plaza
Skokie, IL 60076

Phone

(847) 677-2404

Fax

(847) 677-7432

NPI assigned

Sep 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Elliot Abt, DDS

Title

Dentist Partner

Phone

(847) 177-2404

Specialties & licenses 1

Addresses

Other names 1

• Paul Willis DDS Elliot Abt DDS MS Randall Hirsch DDS Other name

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689765679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF ROAD",
            "address_2": "SUITE 1005 2 CONCOURSE OFFICE PLAZA",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "847-677-2404",
            "fax_number": "847-677-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF ROAD",
            "address_2": "SUITE 1005 2 CONCOURSE OFFICE PLAZA",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "847-677-2404",
            "fax_number": "847-677-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIS ABT DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABT",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_title_or_position": "DENTIST PARTNER",
        "authorized_official_telephone_number": "847-177-2404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paul Willis DDS Elliot Abt DDS MS Randall Hirsch DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erica Michelle Wilham
• Judith Anne Wilke
• William J. Kafin, MD.SC
• Cheryl Ann Williams, MS, RDN, LDN, CDCES
• Katherine M Williams, MD
• Paul Jay Willis, DDS
• Jenny Mat-an Willy, RN
• Christine Wilson, APRN
• Jerome Laurence Wilson, PA-C
• Winfield Woods Healthcare Center LLC

• General Practice Dentistry in Skokie, IL
• Providers in Skokie, 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 Aug 22, 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.