Individual provider Active NPI

Robert F Duffy Jr., DDS

  • General Practice Dentistry
  • Vernon Hills, IL
National Provider Identifier
1740215417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1915992 Issued in IL
Practice address
10 W Phillip Rd
Suite128
Vernon Hills, IL 60061-1799
Phone
(847) 367-6410
Fax
(847) 816-3499
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1915992 IL Primary

Addresses

Primary practice location

10 W Phillip Rd
Suite128
Vernon Hills, IL 60061-1799

Mailing address

10 W Phillip Rd
Suite128
Vernon Hills, IL 60061-1799
Phone (847) 367-6410

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1915992ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740215417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W PHILLIP RD",
            "address_2": "SUITE128",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611799",
            "telephone_number": "847-367-6410",
            "fax_number": "847-816-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W PHILLIP RD",
            "address_2": "SUITE128",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611799",
            "telephone_number": "847-367-6410",
            "fax_number": "847-816-3499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "ROBERT",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "1915992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.