Active NPI
Eloisa Garcia, D.D.S.,M.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Chicago, IL
National Provider Identifier
1699969063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- Practice address
- 2642 S Central Park
Chicago, IL 60623-4630 - Phone
- (773) 522-5253
- Fax
- (773) 521-6128
- NPI assigned
- Aug 29, 2007
- Last updated
- Aug 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | IL | Primary |
Addresses
Primary practice location
2642 S Central Park
Chicago, IL 60623-4630
Mailing address
2642 S Central Park
Chicago, IL 60623-4630
Phone (773) 522-5253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019017041 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188345600000",
"number": "1699969063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2642 S CENTRAL PARK",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606234630",
"telephone_number": "773-522-5253",
"fax_number": "773-521-6128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2642 S CENTRAL PARK",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606234630",
"telephone_number": "773-522-5253",
"fax_number": "773-521-6128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "ELOISA",
"name_prefix": "Dr.",
"credential": "D.D.S.,M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-29",
"last_updated": "2007-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.