Patrick Ian Fitzgerald, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

021002186 Issued in IL

Practice address

350 S Northwest Hwy
Suite 116
Park Ridge, IL 60068-4216

Phone

(847) 823-4161

Fax

(847) 823-4163

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 16, 2020 through Jun 16, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268092800000",
    "number": "1730243213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY",
            "address_2": "SUITE 116",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684216",
            "telephone_number": "847-823-4161",
            "fax_number": "847-823-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY",
            "address_2": "SUITE 116",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684216",
            "telephone_number": "847-823-4161",
            "fax_number": "847-823-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "PATRICK",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2010-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019025826",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021002186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Elizabeth Fischer, NP
• Michael Alan Fisher, MD
• Andrew Fishman, MSW, LCSW
• Angela Fishman, PT
• Iris Fitz
• Jan L. Fitzhugh, PSYD
• Kathryn Fix, DO
• Matthew Norton Flanagan, M.D.
• Denise K Fleig, APN
• Corinne Rae Fleming, PSYD

• Endodontics in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.