DCP OF ILLINOIS - CRYSTAL LAKE (NPI# 1003089251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003089251 |
| Entity Type | Organization |
| Organization Name | DCP OF ILLINOIS - CRYSTAL LAKE |
| Practice Address |
1145 South Route 31 Siute J Crystal Lake IL 60039 |
| Mailing Address |
5875 Landerbrook Dr #250 Mayfield Heights OH 44124-6511 |
| Practice Telephone | 8154775399 |
| Practice Fax Number | 8154772593 |
| Mailing Telephone | 8004874867 |
| Mailing Fax Number | 2165937533 |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |
| Authorized Official Name | SHANNON SPENGLER (CREDENTIALING) |
| Authorized Official Telephone | 8004874867 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
1145 SOUTH ROUTE 31 SIUTE J |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316017155 | Douglas A Henning | Pediatrics | 390 E Congress Pkwy, Ste M, Crystal Lake, IL 60039-0619 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992853 | Krista Lynae Lambert | Counselor | 1064 Plum Tree Dr, Crystal Lake, IL 60014-8310 | 2020-11-05 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1922614429 | Leann Mcmonigal | Registered Nurse | 716 Concord Dr, Crystal Lake, IL 60014-1820 | 2020-09-20 |
| 1982210654 | Brittany Michelle Weber | Physician Assistant | 525 E Congress Pkwy Ste 200, Crystal Lake, IL 60014-6271 | 2020-09-18 |
| 1164037495 | Brett David Freitag | Optometrist | 5006 Northwest Hwy, Crystal Lake, IL 60014-7339 | 2020-09-14 |
| 1851901276 | Jh Counseling Services, LLC | Counselor | 457 Coventry Ln Ste 121, Crystal Lake, IL 60014-7571 | 2020-08-01 |
| 1275141475 | Rebecca Cole | Developmental Therapist | 5811 Wild Plum Rd, Crystal Lake, IL 60014-4642 | 2020-07-14 |
| 1689291684 | Erin Ryan | Acupuncturist | 457 Coventry Ln Ste 122, Crystal Lake, IL 60014-7571 | 2020-06-25 |
| 1700402203 | Edian Banuelos | Pharmacist | 1205 S State Route 31, Crystal Lake, IL 60014-8213 | 2020-06-19 |
| 1770109381 | Zulema Carrillo Gonzalez | Occupational Therapy Assistant | 381 W Terra Cotta Ave Apt 4, Crystal Lake, IL 60014-3519 | 2020-06-19 |
| Find all providers in CRYSTAL LAKE | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275010134 | Muizz Merchant | Dentist | 720 Cog Cir Ste H, Crystal Lake, IL 60014-7301 | 2018-07-24 |
| 1831485929 | Ludford Dental, P.C. | Dentist | 6315 Northwest Hwy, Suite A, Crystal Lake, IL 60014-7939 | 2011-06-27 |
| 1700038908 | Bhawna Prasad | Dentist | 5911 Northwest Hwy., Ste. 104 Windsor Dental, P.C., Crystal Lake, IL 60014 | 2008-10-21 |
| 1437305927 | Gerald Miller | Dentist | 600 Dakota St Ste A, Crystal Lake, IL 60012-3742 | 2008-08-15 |
| 1427214030 | Joseph A Fritz | Dentist | 388 W Virginia St, Crystal Lake, IL 60014-5755 | 2008-08-03 |
| 1730346750 | Donald K Jones | Dentist | 1024 S Mchenry Ave, Crystal Lake, IL 60014-7477 | 2008-05-19 |
| 1497926299 | Robert Henry Basile | Dentist | 385 Millennium Dr, Suite B, Crystal Lake, IL 60012-3761 | 2008-03-19 |
| 1902020464 | David W Bojan | Dentist | 1024 Mchenry Ave Ste H, Crystal Lake, IL 60014-7477 | 2007-04-13 |
| 1508909573 | Tami L Zuck | Dentist | 360 N Terra Cotta Rd, Suite #d, Crystal Lake, IL 60012-3749 | 2007-02-15 |
| 1063577179 | The Oaks Dental Center, Ltd. | Dentist | 8600 Us Highway 14, Suite 203, Crystal Lake, IL 60012-2706 | 2006-12-27 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60039 |
Please comment or provide details below to improve the information on DCP OF ILLINOIS - CRYSTAL LAKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.