Individual provider Active NPI

Richard Tage Welindt, DDS

  • Dentist
  • Oak Park, IL
National Provider Identifier
1851401962
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
1515 N Harlem Ave
Suite 200
Oak Park, IL 60302-1250
Phone
(708) 848-2853
Fax
(708) 848-1330
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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

1515 N Harlem Ave
Suite 200
Oak Park, IL 60302-1250

Mailing address

1515 N Harlem Ave
Suite 200
Oak Park, IL 60302-1250
Phone (708) 848-2853

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
I20150218000438 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7719202605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019019606ILMDDentist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851401962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N HARLEM AVE",
            "address_2": "SUITE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021250",
            "telephone_number": "708-848-2853",
            "fax_number": "708-848-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N HARLEM AVE",
            "address_2": "SUITE 200",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021250",
            "telephone_number": "708-848-2853",
            "fax_number": "708-848-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELINDT",
        "first_name": "RICHARD",
        "middle_name": "TAGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "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 Oak Park, IL

Sources for this page

Verify at the official NPI Registry.