KATHLEEN MCCORMICK
NPI 1104168442
Dentist in Maywood, IL

Q: What is Kathleen Mccormick's NPI number?

The NPI number for Kathleen Mccormick is 1104168442. It was assigned to this individual provider in the NPPES registry on March 25, 2013.

Q: What is Kathleen Mccormick's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Kathleen Mccormick enrolled in Medicare?

No. Kathleen Mccormick has opted out of Medicare through September 24, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since March 25, 2013Opted out of Medicare · through Sep 24, 2027

2160 S 1ST AVE, MAYWOOD, IL 60153(708) 327-3041(708) 327-3489 Get Directions Write a Review

NPPES record last updated: July 22, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kathleen Mccormick NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHLEEN MCCORMICK (NPI 1104168442) is an individual dentist in Maywood, Illinois, licensed in Illinois (018.001867) and active in the NPI registry since March 2013. She has opted out of Medicare through September 24, 2027.

NPPES Registry Identity

NPI1104168442

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameKATHLEEN MCCORMICK

Location Address2160 S 1ST AVEMaywood, IL 60153-3328

Mailing Address2160 S 1st AveMaywood, IL 60153-3328

Phone(708) 327-3041

Fax(708) 327-3489

Sole ProprietorYes

Enumeration DateMarch 25, 2013

Last NPPES UpdateJuly 22, 2013

✔ NPI 1104168442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in IL · 018.001867

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

2160 S 1ST AVE, Maywood, IL 60153

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Kathleen Mccormick has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 24, 2015 through September 24, 2027.

Opt-Out Effective DateSeptember 24, 2015

Opt-Out In Effect ThroughSeptember 24, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60153 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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