Active NPI
Leslee D Rutherford, D.D.S.
- Pediatric Dentistry
- Chicago, IL
National Provider Identifier
1710094768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 021.002397
- Practice address
- 7131-A South Jeffery Boulevard
Chicago, IL 60649 - Phone
- (773) 256-0256
- Fax
- (773) 363-5493
- NPI assigned
- Aug 24, 2006
- Last updated
- Mar 3, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-026451 | IL | |
| Pediatric Dentistry | 1223P0221X | 021.002397 | IL | Primary |
Addresses
Primary practice location
7131-A South Jeffery Boulevard
Chicago, IL 60649
Mailing address
7131-A S Jeffery Blvd
Chicago, IL 60649
Phone (773) 256-0526
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-026451 | IL | MD | Dentist |
| 021.002397 | IL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456963200000",
"number": "1710094768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7131-A S JEFFERY BLVD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60649",
"telephone_number": "773-256-0526",
"fax_number": "773-363-5493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7131-A SOUTH JEFFERY BOULEVARD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60649",
"telephone_number": "773-256-0256",
"fax_number": "773-363-5493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTHERFORD",
"first_name": "LESLEE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2016-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-026451",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021.002397",
"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 Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.