Individual provider Active NPI

Lee Stansbury

  • Dentist
  • Chicago, IL
National Provider Identifier
1881879666
Registry record updated Dec 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
1802 W Chicago Ave
Chicago, IL 60622-5512
Phone
(773) 276-0633
Fax
(773) 276-0687
NPI assigned
Dec 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 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

1802 W Chicago Ave
Chicago, IL 60622-5512

Mailing address

1802 W Chicago Ave
Chicago, IL 60622-5512
Phone (773) 276-0633

Other names 1

  • Lee Stansbury Former name

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
019016644ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1198972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198972800000",
    "number": "1881879666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225512",
            "telephone_number": "773-276-0633",
            "fax_number": "773-276-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 W CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225512",
            "telephone_number": "773-276-0633",
            "fax_number": "773-276-0687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANSBURY",
        "first_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-30",
        "last_updated": "2007-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE",
            "last_name": "STANSBURY",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 30, 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.