Individual provider Active NPI

Michael Nicholas Korompilas, D.D.S.

  • General Practice Dentistry
  • Northbrook, IL
National Provider Identifier
1780888651
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
1310 Shermer Rd
Suite 50
Northbrook, IL 60062-4579
Phone
(847) 272-0049
Fax
(847) 272-6474
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
Yes

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 IL Primary

Addresses

Primary practice location

1310 Shermer Rd
Suite 50
Northbrook, IL 60062-4579

Mailing address

1310 Shermer Rd
Suite 50
Northbrook, IL 60062-4579
Phone (847) 272-0049

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

LicenseStateTypeSpecialty
019 021675ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780888651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SHERMER RD",
            "address_2": "SUITE 50",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624579",
            "telephone_number": "847-272-0049",
            "fax_number": "847-272-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SHERMER RD",
            "address_2": "SUITE 50",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624579",
            "telephone_number": "847-272-0049",
            "fax_number": "847-272-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROMPILAS",
        "first_name": "MICHAEL",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, 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.