Angela Bogacki Skidmore, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025896 Issued in IL

Practice address

988 S Bartlett Rd
Bartlett, IL 60103-6500

Phone

(630) 289-4288

Fax

(630) 289-4468

NPI assigned

Sep 6, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Angela Skidmore DDS PC

  • Dentist
  • Bartlett, IL
  • NPI 1518375211
  NPD (past) Authorized official

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1720072762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 S BARTLETT RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601036500",
            "telephone_number": "630-289-4288",
            "fax_number": "630-289-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 S BARTLETT RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601036500",
            "telephone_number": "630-289-4288",
            "fax_number": "630-289-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "ANGELA",
        "middle_name": "BOGACKI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ruth Shipp, RN, CRNFA
• Nirmala R Shroff, M.D.
• Cara K Siebert, LCPC
• Cynthia Michelle Simpson, CLC, CD
• Indu Singha, OTR
• Skyline Medical Services
• Elizabeth Ann Slevira, LCPC, CADC
• Hannah Kathleen Slinkman, ATC
• Smart Choice MRI LLC
• Smiles Forever, LLC

• General Practice Dentistry in Bartlett, IL
• Providers in Bartlett, 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 May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.