MRS. KELLY ANNE MACK (NPI# 1245308899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245308899 |
| Entity Type | Individual |
| Full Name | MRS. KELLY ANNE MACK |
| Credential | RD4 |
| Practice Address |
55 E Loop Rd Grove Dental Assoc Suite 201 Wheaton IL 60187 |
| Mailing Address |
621 Glacier Trail Roselle IL 60172 |
| Practice Telephone | 6306538899 |
| Mailing Telephone | 6309800992 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578896460 | Kelly Mack | Speech-Language Pathologist | 2124 16th St, Boulder, CO 80302-4354 | 2009-09-10 |
| 1215184056 | Kelly Mack | Physical Therapist | 107 Holly Creek Dr, Irmo, SC 29063-8918 | 2008-08-23 |
| 1780702472 | Kelly Wade Mack | Dentist | 2200 Horseshoe Ln, Longview, TX 75605-5648 | 2007-03-27 |
| 1396813960 | Kelly Leigh Mack | Physician Assistant | 995 N. Prince Frederick Blvd, Suite 204, Prince Frederick, MD 20678 | 2006-12-01 |
| 1003468273 | Kelly Lynne Mack | Nurse Practitioner | 2215 Burdett Ave, Troy, NY 12180-2466 | 2019-07-09 |
| 1972933646 | Kelly Mack | Physical Therapy Assistant | 44480 W Honeycutt Rd, #106, Maricopa, AZ 85138-2903 | 2013-11-17 |
| 1164692455 | Kelly Jene Mack | Counselor | 3737 Portland Rd Ne, Salem, OR 97301-0311 | 2008-03-03 |
| 1457471542 | Kelly S Mack | Nurse Practitioner | 6001 Research Park Blvd, Madison, WI 53719 | 2007-03-30 |
| 1982742888 | Kelly C Mack | Nurse Practitioner | 1800 Williams St, Suite 200, Denver, CO 80218-1234 | 2007-02-02 |
| Street Address |
55 E LOOP RD GROVE DENTAL ASSOC SUITE 201 |
| City | WHEATON |
| State | IL |
| Zip Code | 60187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659345759 | Robbin L Mitchell | Chiropractor | 55 E Loop Rd, Suite #203, Wheaton, IL 60187-2038 | 2006-02-15 |
| 1447611090 | Christienne Grunenwald | Pediatrics | 55 E Loop Rd, Suite 301, Wheaton, IL 60189-1938 | 2016-03-10 |
| 1104072149 | Catherine M Moroni | Nurse Practitioner | 55 E Loop Rd, Suite 301, Wheaton, IL 60189-1938 | 2008-08-11 |
| 1437345212 | Vanda L Marsh | Nurse Practitioner | 55 E Loop Rd, Suite 301, Wheaton, IL 60187-2038 | 2007-09-14 |
| 1487840252 | Wheaton Pediatrics, Ltd. | Pediatrics | 55 E Loop Rd, Suite 301, Wheaton, IL 60187-2038 | 2007-09-14 |
| 1669679395 | Scot William Lightbody | Hearing Instrument Specialist | 55 E Loop Rd, Suite 204, Wheaton, IL 60187-2038 | 2007-06-27 |
| 1871650606 | Maureen E Quirk | Dental Hygienist | 55 E Loop Rd, Ste 201, Wheaton, IL 60187-2038 | 2007-01-02 |
| 1699836536 | Jeanette Alison Balis | Dental Hygienist | 55 E Loop Rd, Suite 201 Grove Dental, Wheaton, IL 60187 | 2006-12-13 |
| 1285795989 | Lynn Mary Ables | Pediatrics | 55 E Loop Rd, Suite 301, Wheaton, IL 60187 | 2006-12-13 |
| 1073674784 | Peter Ihor Liber | Pediatrics | 55 E Loop Rd, 301, Wheaton, IL 60187 | 2006-12-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811510738 | Arielle Susan Kalvelage | Counselor | Central Public Health Center (cphc), 111 N. County Farm Road, Wheaton, IL 60187 | 2020-05-27 |
| 1801418363 | Peter Gerard Harvey | Acupuncturist | 200 East Willow Avenue, Suite 202, Wheaton, IL 60187 | 2020-05-07 |
| 1760028823 | Teresa Clasen | Counselor | 222 Willow Ave, Wheaton, IL 60187 | 2019-11-25 |
| 1821630757 | Eastern Healing Inc. | Acupuncturist | 200 E. Willow Ave., Suite 202, Wheaton, IL 60187 | 2019-10-11 |
| 1952816282 | Caprishea Jones | Counselor | 111 N County Farm Road, Wheaton, IL 60187 | 2017-12-08 |
| 1265880330 | Bryan Cairncross | Specialist/Technologist | 1503 Beecher Ave., Wheaton, IL 60187 | 2016-05-31 |
| 1811357544 | Patricia Diaz | Nurse Practitioner | 0n620 West Street, Wheaton, IL 60187 | 2016-02-23 |
| 1962819227 | Breakthrough Care Center | Clinic/Center | 150 E. Willow Ave, Ste 100, Wheaton, IL 60187 | 2014-07-18 |
| 1780005587 | Kyler Mulhauser | Counselor | 600 W. Roosevelt Rd, Suite A2, Wheaton, IL 60187 | 2013-12-20 |
| 1538593074 | Deborah Bates | Psychologist | 300 E Roosevelt Rd Ste 105, Wheaton, IL 60187 | 2013-08-31 |
| Find all providers in zip 60187 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760550313 | Emily Ann Barenbrugge | Dental Hygienist | 55 East Loop Road, Suite 201, Wheaton, IL 60187 | 2006-12-01 |
| 1871650606 | Maureen E Quirk | Dental Hygienist | 55 E Loop Rd, Ste 201, Wheaton, IL 60187-2038 | 2007-01-02 |
| 1699836536 | Jeanette Alison Balis | Dental Hygienist | 55 E Loop Rd, Suite 201 Grove Dental, Wheaton, IL 60187 | 2006-12-13 |
| 1497823025 | Jennifer Joan Shubat | Dental Hygienist | 55 E Loop Rd, Ste 201, Wheaton, IL 60187 | 2006-12-01 |
| 1639247265 | Dori Jean Wachowski | Dental Hygienist | 55 E Loop Rd, Suiete 201 Grove Dental, Wheaton, IL 60187 | 2006-12-01 |
| 1578631107 | Andrea Nichole Trattner | Dental Hygienist | 55 E Loop Rd, Ste 201 Grove Dental, Wheaton, IL 60187 | 2006-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457950891 | Laura Jean Baus | Dental Hygienist | 519 E Bode Rd, Streamwood, IL 60107-6897 | 2020-10-17 |
| 1972114551 | Chelsea R Black | Dental Hygienist | 428 N 8th St, Auburn, IL 62615-1006 | 2020-08-16 |
| 1912518150 | Nicole Lynn Connell | Dental Hygienist | 204 Hwy 164 East, Oquawka, IL 61469 | 2020-08-12 |
| 1073122016 | Ann Frederickson | Dental Hygienist | 9851 S Homan Ave, Evergreen Park, IL 60805-3041 | 2020-07-27 |
| 1588289805 | Joy Lantz | Dental Hygienist | 16335 Harlem Ave Ste 422, Tinley Park, IL 60477-2877 | 2020-06-11 |
| 1740805381 | Goran Lazic | Dental Hygienist | 109 Annapolis Dr, Vernon Hills, IL 60061-2057 | 2020-06-09 |
| 1568085991 | Amy Lappin | Dental Hygienist | 335 Hidden Creek Rd, Lake Zurich, IL 60047-7116 | 2020-05-20 |
| 1114540630 | Krista M Walsh | Dental Hygienist | 890 Brookforest Ave Unit D, Shorewood, IL 60404-8838 | 2020-05-19 |
| 1881214658 | Sherri Foran | Dental Hygienist | 127 60th St, Downers Grove, IL 60516-2038 | 2020-04-22 |
| 1124666573 | Katherine Lynn Leiva | Dental Hygienist | 1791 Dempsey Cir, Pingree Grove, IL 60140-8019 | 2019-12-17 |
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| 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.