CRYSTAL LAKE DENTAL ASSOCIATES
NPI 1871702985
Clinic/Center - Dental in Crystal Lake, IL
NPI Status: Active since May 22, 2007
Contact Information
280 MEMORIAL CT STE B
CRYSTAL LAKE, IL
ZIP 60014
Phone: (815) 459-2202
Fax: (815) 459-2787
- Organization
- Clinic/Center
- Dental
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 14D1080638
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-30-2026
About CRYSTAL LAKE DENTAL ASSOCIATES
This page provides the complete NPI Profile along with additional information for Crystal Lake Dental Associates, a provider established in Crystal Lake, Illinois operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1871702985 assigned on May 2007. The practitioner's primary taxonomy code is 261QD0000X with license number 1915895 (IL). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Crystal Lake Dental Associates. The authorized official of this NPI record is Dr. Phillip C Neal Dds (President)
- NPI
- 1871702985
- Provider Legal Name
- NEAL AND ASSOCIATES PC
- Other Organization Name
- CRYSTAL LAKE DENTAL ASSOCIATES
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 280 MEMORIAL CT STE B CRYSTAL LAKE, IL 60014
- Location Phone
- (815) 459-2202
- Location Fax
- (815) 459-2787
- Mailing Address
- 122 DOLE AVE CRYSTAL LAKE, IL 60014
- Mailing Phone
- (815) 459-9389
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-22-2007
- Last Update Date
- 08-22-2020
- Code Navigator
Crystal Lake Dental Associates is a medicare supplier with PTAN 20629637 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Prosthetic Lenses: Conventional Eyeglasses or Prosthetic Lenses: Conventional Contact Lenses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Dental
- Taxonomy Code
- 261QD0000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 1915895
- License State
- IL
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- Standard Silver + Vision + Adult Dental - EPO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Principal Bronze HSA - EPO
- Principal Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20629637
- Accepts Medicare Assignment
- YES
- Specialities List
- Optician.
- Provider Type List
- PHYSICIAN – OPHTHALMOLOGY.
- Competitive Bidding
- NO
Supplies List
- Prosthetic Lenses: Conventional Eyeglasses - Conventional Eyeglasses
- Prosthetic Lenses: Conventional Contact Lenses - Conventional Contact Lenses
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D1080638
- Facility Type
- Physician Office
- Certificate Effective Date
- May 31, 2024
- Certificate Expiration Date
- May 30, 2026
- Laboratory Director
- MATILDA ROSANWO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Crystal Lake Dental Associates to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1871702985, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
CRYSTAL LAKE, IL 60014
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1871702985, enumerated as an "organization" on May 22, 2007.
The provider is located at 280 MEMORIAL CT STE B CRYSTAL LAKE, IL 60014 and the phone number is (815) 459-2202.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health. Please consult your insurance carrier or call the provider to verify.
