Patrick Allen Pecora, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

586 Duane St Ste 301
Glen Ellyn, IL 60137-4639

Phone

(630) 469-0296

Fax

(630) 545-9155

NPI assigned

Aug 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902919848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 CHATHAM DR",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601878116",
            "telephone_number": "630-668-3025",
            "fax_number": "630-545-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 DUANE ST STE 301",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374639",
            "telephone_number": "630-469-0296",
            "fax_number": "630-545-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECORA",
        "first_name": "PATRICK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathway Therapy Services PLLC
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• Miriam Paull-Binette, LCSW
• Kelli Marie Paulus, HBCE, PES
• Peak Surgical Assistant Inc
• Penny Drop Therapy, Inc
• Christine Marie Penway, DPT
• Sally Pepping, D.C.
• Jeanne P. Perkins, AUD
• Andrea J. Perri, APN-CNP

• General Practice Dentistry in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.