WALTER KELLEY FARRIS (NPI# 1780235655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780235655 |
| Entity Type | Individual |
| Full Name | WALTER KELLEY FARRIS |
| Credential | DMD |
| Practice Address |
1515 N Harlem Ave Ste 200 Oak Park IL 60302-1277 |
| Mailing Address |
401 E Ontario St Apt 2506 Chicago IL 60611-4417 |
| Practice Telephone | 7088482853 |
| Mailing Telephone | 8158611308 |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019.032072 | IL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 301 E Calhoun St, Woodstock, IL 600984290 | 8153387774 |
| Street Address |
1515 N HARLEM AVE STE 200 |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302-1277 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
| 1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
| 1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
| 1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
| 1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
| 1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
| Find all providers in zip 60302 | ||||
| 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 |
|---|---|---|---|---|
| 1629620273 | Fandah A. Hamdi | Dentist | 1136 Pleasant St Apt 2e, Oak Park, IL 60302-3043 | 2019-07-14 |
| 1245799956 | Tad A Erickson Dds A Dental Corporation | Dentist | 346 Kanan Rd Ste 101, Oak Park, CA 91377-1165 | 2019-03-13 |
| 1891259768 | D2 Dental of Lansing, P.C. | Dentist | 1 Chicago Ave, Oak Park, IL 60302-2432 | 2019-01-24 |
| 1104259407 | Ruoyu Pang | Dentist | 340 S Austin Blvd, Apt 3k, Oak Park, IL 60304-1743 | 2013-08-10 |
| 1962843771 | Sinan A Shisha | Dentist | 13231 W 10 Mile Rd, Oak Park, MI 48237-4631 | 2013-07-09 |
| 1295173953 | Oak Park Dental Studio | Dentist | 6630 Roosevelt Rd, Oak Park, IL 60304-2059 | 2013-06-04 |
| 1255623450 | Maria Cristina Velarde | Dentist | 608 Lindero Canyon Rd, Oak Park, CA 91377-5455 | 2011-05-05 |
| 1740515568 | James E Scapillato | Dentist | 6943 North Ave, Oak Park, IL 60302-1024 | 2009-10-13 |
| 1851529382 | Chicago Dental Spa, Ltd. | Dentist | 106 S Ridgeland Ave, #408, Oak Park, IL 60302-4613 | 2009-06-23 |
| 1023261617 | St.george Family Dentistry P.c | Dentist | 10470 W 9 Mile Rd, Oak Park, MI 48237-2914 | 2008-10-28 |
| Find all providers in OAK PARK | ||||
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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.