LAGRANGE PERIODONTICS, LTD (NPI# 1023175775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023175775 |
| Entity Type | Organization |
| Organization Name | LAGRANGE PERIODONTICS, LTD |
| Practice Address |
6520 Joliet Rd Countryside IL 60525 |
| Mailing Address |
6520 Joliet Rd Countryside IL 60525-4649 |
| Practice Telephone | 7083544545 |
| Practice Fax Number | 7083540336 |
| Mailing Telephone | 7083544545 |
| Mailing Fax Number | 7083540336 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2019-10-30 |
| Authorized Official Name | DR. MICHELLE P JENNINGS (PRESIDENT/PERIODONTIST) |
| Authorized Official Telephone | 7083544545 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
21001423 | IL | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
21001561 | IL | Dental Providers |
| Street Address |
6520 JOLIET RD |
| City | COUNTRYSIDE |
| State | IL |
| Zip Code | 60525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205054541 | Michelle P Jennings | Dentist | 6520 Joliet Rd, Countryside, IL 60525 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063923837 | Cheryl Buhrke | Speech-Language Pathologist | 1301 W. Cossitt Ave., La Grange, IL 60525 | 2017-10-19 |
| 1881113462 | Karen Aluise | Speech-Language Pathologist | 6818 Joliet Rd. #2, Indian Head Park, IL 60525 | 2017-09-14 |
| 1689126997 | Adriana Digianfilippo | Occupational Therapist | 18 N. Catherine, Lagrange, IL 60525 | 2016-11-03 |
| 1679953582 | Paulina Pinzon | Counselor | 6548 Laurel Avenue, Indian Head Park, IL 60525 | 2015-06-05 |
| 1639446925 | Aarti Parikh | Pharmacist | 6600 S. Willow Springs Rd, Indian Head Park, IL 60525 | 2011-11-30 |
| 1831476795 | Jessica E Feller | Physician Assistant | 6555 South Willow Springs Road, Suite 6, Countryside, IL 60525 | 2011-11-07 |
| 1477833218 | Robyn Lee Frendling | Behavioral Analyst | 9649 W. 55th St, Countryside, IL 60525 | 2011-08-25 |
| 1457630543 | Kerri E Kabela | Physical Therapist | 705 W. Plainfield Rd, Suite 1, Countryside, IL 60525 | 2011-08-08 |
| 1275826984 | G&u Orthopedic, LLC | Durable Medical Equipment & Medical Supplies | 106 W. Calendar Ave., 127, La Grange, IL 60525 | 2011-05-27 |
| 1952609752 | Athletic and Therapeutic Institute of Naperville, LLC | Physical Therapist | 705 W. Plainfield Road, Suite 1, Countryside, IL 60525 | 2011-03-03 |
| Find all providers in zip 60525 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558546390 | Eugene J Buksa | Dentist | 475 W 55th St Ste 201, Countryside, IL 60525-3566 | 2007-12-28 |
| 1205054541 | Michelle P Jennings | Dentist | 6520 Joliet Rd, Countryside, IL 60525 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309399 | Dominik Dubravec Dds Mmsc PC | Dentist | 555 W Court St Ste 202, Kankakee, IL 60901-3674 | 2020-09-02 |
| 1598374167 | Dubravec Periodontal Specialists PC | Dentist | 20635 Abbey Woods Ct N Ste 203, Frankfort, IL 60423-3186 | 2020-07-29 |
| 1972145183 | Dental Dream Team Associates LLC Yetta Mccullom Sole Mbr | Dentist | 820 E 87th St Ste 201, Chicago, IL 60619-6256 | 2019-10-09 |
| 1083192389 | Amirreza Ghassemi | Dentist | 2800 College Ave Bldg 285, Alton, IL 62002-4742 | 2018-07-30 |
| 1508355678 | Periodontal Associates, LLP | Dentist | 845 N Michigan Ave Ste 940w, Chicago, IL 60611-2216 | 2018-05-04 |
| 1043750714 | Bloomingdale Dental Rez, PC | Dentist | 1 Tiffany Pt Ste 209, Bloomingdale, IL 60108-2916 | 2017-03-01 |
| 1114398831 | Dubravec Periodontal Associates, PC | Dentist | 1900 Spring Rd, Suite 205, Oak Brook, IL 60523-1447 | 2015-10-08 |
| 1689059297 | Amer Atassi | Dentist | 6224 S Elm St, Burr Ridge, IL 60527-5228 | 2015-07-24 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
| 1215345939 | Mark Kolozenski, Dds, Ms, PC | Dentist | 10083 W Lincoln Hwy, Frankfort, IL 60423-1272 | 2014-07-25 |
| Find all providers with the same taxonomy | ||||
| City | COUNTRYSIDE |
| Zip Code | 60525 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.