Active NPI
Cathleen Ann Nick, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1770078958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- N387207
- Practice address
- 2334 W Lawrence Ave Ste 201
Chicago, IL 60625-1046 - Phone
- (773) 458-4078
- NPI assigned
- Jun 28, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | N387207 | MI | Primary |
Addresses
Primary practice location
2334 W Lawrence Ave Ste 201
Chicago, IL 60625-1046
Mailing address
6336 N Knox Ave
Chicago, IL 60646-4412
Phone (773) 458-4078
Other practice location 1
1469 S 70th St
West Allis, WI 53214-4814
Phone (773) 458-4078
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 |
|---|---|---|---|
| N387207 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530144000000",
"number": "1770078958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6336 N KNOX AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606464412",
"telephone_number": "773-458-4078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2334 W LAWRENCE AVE STE 201",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606251046",
"telephone_number": "773-458-4078"
}
],
"practiceLocations": [
{
"address_1": "1469 S 70th St",
"address_purpose": "LOCATION",
"city": "West Allis",
"state": "WI",
"postal_code": "532144814",
"country_code": "US",
"telephone_number": "773-458-4078",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICK",
"first_name": "CATHLEEN",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-28",
"last_updated": "2018-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "N387207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.