Active NPI
Angelique Ford
- Endodontics
- Chicago, IL
National Provider Identifier
1710136635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 021002281
- Practice address
- 533 E 33Rd PL
607
Chicago, IL 60616-4112 - Phone
- (773) 544-5302
- NPI assigned
- Sep 16, 2008
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 021002281 | IL | Primary |
| General Practice Dentistry | 1223G0001X | 019026718 | IL |
Addresses
Primary practice location
533 E 33Rd PL
607
Chicago, IL 60616-4112
Mailing address
533 E 33Rd PL
607
Chicago, IL 60616-4112
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 |
|---|---|---|---|
| 021002281 | IL | MD | Endodontist |
| 019026718 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1710136635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533 E 33RD PL",
"address_2": "607",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606164112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "533 E 33RD PL",
"address_2": "607",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606164112",
"telephone_number": "773-544-5302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "ANGELIQUE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "IL",
"license": "021002281",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019026718",
"primary": false
}
],
"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 Sep 16, 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.