NPIMap

Organization Active NPI

Fischl Dental Associates, P.C.

  • Dentist
  • Evanston, IL
National Provider Identifier
1871718452
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FISCHL DENTAL ASSOCIATES, P.C.
Practice address
636 Church Street
Suite 200W
Evanston, IL 60201-4578
Phone
(847) 864-0822
Fax
(847) 864-9799
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Paul L Fischl, D.D.S.NPI 1205904547
Title
President
Phone
(847) 864-0822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 060006229 020004357 IL

Addresses

Primary practice location

636 Church Street
Suite 200W
Evanston, IL 60201-4578

Mailing address

636 Church Street
Suite 200W
Evanston, IL 60201-4578
Phone (847) 864-0822

Other names 1

  • Fischl and Weiss Dental Associates, P.C. Former legal business name

National Provider Directory

National Provider Directory

Locations

636 Church St
Ste 200W
Evanston, IL 60201
Phone (847) 448-1684

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1871718452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 CHURCH STREET",
            "address_2": "SUITE 200W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014578",
            "telephone_number": "847-864-0822",
            "fax_number": "847-864-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 CHURCH STREET",
            "address_2": "SUITE 200W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014578",
            "telephone_number": "847-864-0822",
            "fax_number": "847-864-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISCHL DENTAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "FISCHL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-864-0822",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "060006229 020004357",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fischl and Weiss Dental Associates, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.