Gerald Leon Wine, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019013232 Issued in IL

Practice address

2632 W Division St
Chicago, IL 60622

Phone

(773) 235-0980

Fax

(773) 235-1249

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Gerald L Wine DDS and Daniel L Lassman DDS LTD

  • Dentist
  • Chicago, IL
  • NPI 1922146778
  NPD (past)
• Sanjeet Raj Singh Parmar DDS LTD

  • Dental Clinic/Center
  • Chicago, IL
  • NPI 1598251878
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740326537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "773-235-0980",
            "fax_number": "773-235-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60622",
            "telephone_number": "773-235-0980",
            "fax_number": "773-235-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINE",
        "first_name": "GERALD",
        "middle_name": "LEON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019013232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Windy City Speech, LLC
• Windy City Surgical Services, LLC
• Windy City Therapy LLC
• Windy City Wellness, SC
• Windycitywheelchairservice
• Paul Ethan Wine, DDS
• Katherine Elizabeth Winebrake
• Cain Winebrenner, DC
• Lauren F Wineburgh, MA CCC-SLP
• Doris Wineman, PH.D, L.C.S.W.

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• 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.