Kevin Jack Otte in Great Lakes - General Practice
Kevin Jack Otte - NPI 1477532968
Kevin Jack Otte is a General Practice in Great Lakes, Illinois. Kevin Jack Otte practices all healthcare services and medical treatments related to General Practice. The NPI Number for Kevin Jack Otte is 1477532968. The last update date is 2007-11-19.
Kevin Jack Otte's current location address is Nhcgl 3001a Sixth Street, Great Lakes, Illinois. You can contact this provider via phone number 8476885568. The mailing address for Kevin Jack Otte is Nhcgl 3001a Sixth Street, Great Lakes, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Jack Otte |
|---|---|
| Address | Nhcgl 3001a Sixth Street, Great Lakes, Illinois |
| Phone Number | 8476885568 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1477532968 |
|---|---|
| Provider Enumeration Date | 2006-01-12 |
| Last Updated Date | 2007-11-19 |
Provider Mailing Address Detail
| Address | Nhcgl 3001a Sixth Street |
|---|---|
| City | Great Lakes |
| State | Illinois (IL) |
| Post Code | 600880000 |
| Phone Number | 8476885568 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 19023277 |
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Definition: 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. |
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What is the unique identifier code issued to Kevin Jack Otte by the Centers for Medicare & Medicaid Services?
The Kevin Jack Otte has been assigned the NPI (National Provider Identifier) 1477532968. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Kevin Jack Otte's facilities are geographically located?
The facilities of Kevin Jack Otte are physically situated at the following location: Nhcgl 3001A Sixth Street, Great Lakes, IL, 600880000.
What is Kevin Jack Otte's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kevin Jack Otte's specialized field of practice is General Practice, and the corresponding taxonomy code that categorizes this area of specialization is 1223G0001X.
On what date did Kevin Jack Otte receive its 1477532968 assignment from the Centers for Medicare & Medicaid Services?
The Kevin Jack Otte was assigned its 1477532968 on 2006-01-12, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Kevin Jack Otte most recently updated?
The details pertaining to the Kevin Jack Otte, including its address, specialty, and other relevant information, were last refreshed on 2007-11-19.