Individual provider Active NPI

Richard Charles Kruger, DDS

  • General Practice Dentistry
  • Niles, IL
National Provider Identifier
1821154907
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
9101 N Greenwood Ave Ste 204
Niles, IL 60714-1466
Phone
(847) 827-0660
Fax
(847) 827-0689
NPI assigned
Dec 31, 2006
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

9101 N Greenwood Ave Ste 204
Niles, IL 60714-1466

Mailing address

9101 N Greenwood Ave Ste 204
Niles, IL 60714-1466
Phone (847) 827-0660

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
019014605ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821154907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 N GREENWOOD AVE STE 204",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141466",
            "telephone_number": "847-827-0660",
            "fax_number": "847-827-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N GREENWOOD AVE STE 204",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141466",
            "telephone_number": "847-827-0660",
            "fax_number": "847-827-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGER",
        "first_name": "RICHARD",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-31",
        "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 Niles, 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.