Active NPI
Dale W Kunckel, CSA
- Surgical Assistant
- Arlington Heights, IL
National Provider Identifier
1740524172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 2995
- Practice address
- 309 E Rand Rd
Suite 347
Arlington Heights, IL 60004-3103 - Phone
- (419) 351-8944
- NPI assigned
- Nov 26, 2012
- Last updated
- Nov 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 2995 | OH | Primary |
Addresses
Primary practice location
309 E Rand Rd
Suite 347
Arlington Heights, IL 60004-3103
Mailing address
309 E Rand Rd
Suite 347
Arlington Heights, IL 60004-3103
Phone (877) 230-9617
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 |
|---|---|---|---|
| 2995 | OH | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1740524172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E RAND RD",
"address_2": "SUITE 347",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600043103",
"telephone_number": "877-230-9617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E RAND RD",
"address_2": "SUITE 347",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600043103",
"telephone_number": "419-351-8944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNCKEL",
"first_name": "DALE",
"middle_name": "W",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-26",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "OH",
"license": "2995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.