Individual provider Active NPI

Caroline Witik, D.M.D.

  • Dentist
  • Elk Grove VLG, IL
National Provider Identifier
1922771302
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.033181 Issued in IL
Practice address
717 Meacham Rd
Elk Grove VLG, IL 60007-3000
Phone
(847) 744-5189
NPI assigned
Jul 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.033181 IL Primary

Addresses

Primary practice location

717 Meacham Rd
Elk Grove VLG, IL 60007-3000

Mailing address

7608 Baimbridge Dr
Downers Grove, IL 60516-4450
Phone (630) 391-1882

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
019.033181ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1922771302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7608 BAIMBRIDGE DR",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605164450",
            "telephone_number": "630-391-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 MEACHAM RD",
            "city": "ELK GROVE VLG",
            "state": "IL",
            "postal_code": "600073000",
            "telephone_number": "847-744-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITIK",
        "first_name": "CAROLINE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove VLG, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.