Individual provider Active NPI

Stephanie S Skopek, DDS

  • Dentist
  • Des Plaines, IL
National Provider Identifier
1821211756
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
29 N Broadway St
Des Plaines, IL 60016-2335
Phone
(847) 824-5252
Fax
(847) 824-7434
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

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
Dentist 122300000X IL Primary

Addresses

Primary practice location

29 N Broadway St
Des Plaines, IL 60016-2335

Mailing address

29 N Broadway St
Des Plaines, IL 60016-2335
Phone (847) 824-5252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160205002351 IL Order and Referring Only - DentistPractitioner - Dentist 2860796141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821211756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 N BROADWAY ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162335",
            "telephone_number": "847-824-5252",
            "fax_number": "847-824-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N BROADWAY ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162335",
            "telephone_number": "847-824-5252",
            "fax_number": "847-824-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOPEK",
        "first_name": "STEPHANIE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.