DR. PHILIP E FIDEL DDS NPI 1003008459

Dentist (General Practice) in Chicago, IL

About PHILIP FIDEL

Philip Fidel is a provider in Chicago, IL. The NPI number assigned to this provider is 1003008459. The practitioner's primary taxonomy code is Dentist (1223G0001X). The provider is registered as an individual and their NPI record was last updated 10 years ago.

NPI1003008459 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameDR. PHILIP E FIDEL DDS
Provider Location Address3236 W FULLERTON AVE CHICAGO, IL 60647 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address3236 W FULLERTON AVE CHICAGO, IL 60647 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date08-09-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date08-09-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DR. PHILIP E FIDEL DDS
3236 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
Phone: (773) 276-0300
Fax: (773) 252-5994
Get Directions

Mailing Address

DR. PHILIP E FIDEL DDS
3236 W FULLERTON AVE
CHICAGO, IL
ZIP 60647
Phone: (773) 276-0300
Fax: (773) 252-5994

Primary Taxonomy

Taxonomy Code1223G0001X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationDentist
TypeDental Providers
SpecializationGeneral Practice
License No.01922169
License StateIL
Taxonomy DescriptionA 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.

Map Location


DR. PHILIP E FIDEL DDS address is 3236 W FULLERTON AVE CHICAGO, IL 60647

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1245396126DR. MARCELLA R GUZMAN D.D.S
Individual
Dentist (General Practice)3236 W FULLERTON AVE
CHICAGO, IL 60647
(773) 276-0300
1669734406MARCELLA GUZMAN DDS PC
Organization
Dentist3236 W FULLERTON AVE
CHICAGO, IL 60647
(773) 276-0300