Individual provider Active NPI

George Lenworth Walker, DDS

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1811191190
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19A15006 Issued in IL
Practice address
1515 East 52ND Place
Suite 200
Chicago, IL 60615-4390
Phone
(773) 752-3832
Fax
(773) 752-3879
NPI assigned
Jun 12, 2007
Last updated
Mar 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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 19A15006 IL Primary

Addresses

Primary practice location

1515 East 52ND Place
Suite 200
Chicago, IL 60615-4390

Mailing address

1515 East 52ND Place
Suite 200
Chicago, IL 60615-4390
Phone (773) 752-3832

Other practice location 1

1276 N Clybourn Ave
Chicago, IL 60610-2089
Phone (312) 337-1073

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
19A15006ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1811191190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 EAST 52ND PLACE",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154390",
            "telephone_number": "773-752-3832",
            "fax_number": "773-752-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 EAST 52ND PLACE",
            "address_2": "SUITE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154390",
            "telephone_number": "773-752-3832",
            "fax_number": "773-752-3879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1276 N Clybourn Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606102089",
            "country_code": "US",
            "telephone_number": "312-337-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "GEORGE",
        "middle_name": "LENWORTH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19A15006",
            "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 Mar 18, 2019; 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.