NPIMap

Organization Active NPI

St. Bernard Hospital

Doing business as St. Bernard Hospital Dental Services

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1780993410
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0002303 Issued in IL
Legal business name
ST. BERNARD HOSPITAL
Doing business as
St. Bernard Hospital Dental Services
Practice address
326 W 64TH St
Suite 200
Chicago, IL 60621-3114
Phone
(773) 962-4073
Fax
(773) 962-9276
NPI assigned
Sep 29, 2010
Last updated
Sep 29, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. BERNARD HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Authorized official

Name
Mr. Guy Richard Alton
Title
Chief Financial Officer
Phone
(773) 962-4073

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0002303 IL Primary

Addresses

Primary practice location

326 W 64TH St
Suite 200
Chicago, IL 60621-3114

Mailing address

326 W 64TH St
Suite 200
Chicago, IL 60621-3114
Phone (773) 962-4073

Other names 1

  • ST. BERNARD HOSPITAL DENTAL SERVICES Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Bernard Emerg Physic13 organizations share this tax ID, including this one
Part of
St Bernard Emerg Physic

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

326 W 64th St
Ste 200
Chicago, IL 60621
Phone (773) 962-4073

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1780993410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-4073",
            "fax_number": "773-962-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-4073",
            "fax_number": "773-962-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. BERNARD HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. BERNARD HOSPITAL",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "ALTON",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "773-962-4073",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "0002303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. BERNARD HOSPITAL DENTAL SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 29, 2010; 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.