Individual provider Active NPI

Patricia J Nemec, D.D.S.

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1881897700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019026878 Issued in IL
Practice address
5470 W Madison St
Chicago, IL 60644-4031
Phone
(773) 287-2277
NPI assigned
Jun 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 019026878 IL Primary

Addresses

Primary practice location

5470 W Madison St
Chicago, IL 60644-4031

Mailing address

416 Uvedale Rd
Riverside, IL 60546-1609
Phone (312) 451-3866

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921000661 IL Order and Referring Only - Other (Non-Physician) 0941597876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019026878ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881897700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 UVEDALE RD",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605461609",
            "telephone_number": "312-451-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5470 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444031",
            "telephone_number": "773-287-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMEC",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.