Individual provider Active NPI

Adam Ostrand

  • Dentist
  • Chicago, IL
National Provider Identifier
1699229815
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.030893 Issued in IL
Practice address
801 S Paulina St
Department of Restorative Dentistry
Chicago, IL 60612-7210
Phone
(312) 996-2669
NPI assigned
Aug 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.030893 IL Primary

Addresses

Primary practice location

801 S Paulina St
Department of Restorative Dentistry
Chicago, IL 60612-7210

Mailing address

801 S Paulina St
Department of Restorative Dentistry
Chicago, IL 60612-7210
Phone (320) 420-3917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718000708 IL Order and Referring Only - DentistPractitioner - Dentist 1153656780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.030893ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1699229815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "address_2": "DEPARTMENT OF RESTORATIVE DENTISTRY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "320-420-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S PAULINA ST",
            "address_2": "DEPARTMENT OF RESTORATIVE DENTISTRY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127210",
            "telephone_number": "312-996-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTRAND",
        "first_name": "ADAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.