Chicago Osteopathic Hospital Dental Clinic, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019022626 Issued in IL

Legal business name

CHICAGO OSTEOPATHIC HOSPITAL DENTAL CLINIC, P.C.

Practice address

1525 E. 53Rd St.
#522
Chicago, IL 60615-4530

Phone

(773) 947-4665

Fax

(773) 256-2373

NPI assigned

Oct 2, 2006

Last updated

Jun 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ana C Hernandez

Title

Office Manager

Phone

(773) 947-4665

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William B Wilson Jr., DDS

  • Dentist
  • Chicago, IL
  • NPI 1427218635
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1699868364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E. 53RD ST.",
            "address_2": "#522",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154530",
            "telephone_number": "773-947-4665",
            "fax_number": "773-256-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E. 53RD ST.",
            "address_2": "#522",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154530",
            "telephone_number": "773-947-4665",
            "fax_number": "773-256-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO OSTEOPATHIC HOSPITAL DENTAL CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "773-947-4665",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101659",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chicago Pain & Headache Clinic
• Chicago Pain & Headache Clinic LTD
• Chicago Pain & Headache Clinic, LTD
• Chicago Pain & Orthopedic Institute
• Chicago Pain & Wellness

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, 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 Jun 11, 2008; 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.