NPI |
1497953723 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Entity Type Code |
2 |
The country code in the location address of the provider being identified. |
Employer Identification Number EIN |
|
The telephone number associated with the location address of the provider being identified. |
Provider Organization Name Legal Business Name |
W B HAMEL III DDS PC |
The fax number associated with the location
address of the provider being identified. |
Provider First Line Business Practice Location Address |
210 BURLINGTON AVE |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Business Practice Location Address City Name |
CLARENDON HILLS |
The date that a record was last updated or changed. |
Provider Business Practice Location Address State Name |
IL |
The code designating the provider’s gender if the provider is a person. |
Provider Business Practice Location Address Postal Code |
605141137 |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
Provider Business Practice Location Address Telephone Number |
6303230380 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
6303230522 |
|
Provider Enumeration Date |
7/9/2007 |
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form. |
Last Update Date |
4/25/2023 |
Code indicating the type of identifier currently
or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form. |
Authorized Official Last Name |
HAMEL |
|
Authorized Official First Name |
WILLIAM |
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No |
Authorized Official Middle Name |
BRYAN |
|
Authorized Official Title or Position |
PRESIDENT/ OWNER |
The title or position of the authorized official. |
Authorized Official Telephone Number |
6303230380 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
1223G0001X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider License Number State Code 1 |
IL |
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Organization Subpart |
N |
|
Authorized Official Name Prefix Text |
DR. |
|
Authorized Official Name Suffix Text |
III |
|
Authorized Official Credential Text |
D.D.S. |
|
Healthcare Provider Taxonomy Group 1 |
193400000X SINGLE SPECIALTY GROUP |
|
NPI Certification Date |
4/25/2023 |
|