PERIODONTICS LTD. (NPI# 1043344492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043344492 |
| Entity Type | Organization |
| Organization Name | PERIODONTICS LTD. |
| Practice Address |
4711 Golf Rd Ste 101 Skokie IL 60076-1239 |
| Practice Telephone | 8476757555 |
| Practice Fax Number | 8476753734 |
| Mailing Telephone | 8476757555 |
| Mailing Fax Number | 8476753734 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. STEPHEN P RUSSO (PARTNER) |
| Authorized Official Telephone | 8476757555 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336219856 | Periodontics Ltd. | Dentist | 111 N Wabash Ave Ste 919, Chicago, IL 60602-1932 | 2006-11-09 |
| Street Address |
4711 GOLF RD STE 101 |
| City | SKOKIE |
| State | IL |
| Zip Code | 60076-1239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902456999 | Gateway Foundation, Inc | Clinic/Center | 4028 W. Dempster, Ste 100, Skokie, IL 60076 | 2019-09-12 |
| 1336798255 | Renee Rosenberg | Speech-Language Pathologist | C/o East Prairie School, 7616 N. East Prairie Road, Skoke, IL 60076 | 2019-09-04 |
| 1710531223 | Dw Care Solutions | Hospice Care, Community Based | 4556 Oakton St, Suite 205, Skokie, IL 60076 | 2019-08-01 |
| 1689228157 | Elaine Ng | Pharmacist | 9650 Gross Point Rd Suite 4900, Skokie, IL 60076 | 2019-08-01 |
| 1881169381 | Kathleen Pyles | Registered Nurse | 9650 Gross Point Rd # 4900, Skokie, IL 60076 | 2018-10-10 |
| 1174013452 | Vitae Health of Illinois LLC | Social Worker | 3450 Oakton St, Skokie, IL 60076 | 2018-05-13 |
| 1396253530 | Jodi Novick Okner | Social Worker | 9134 Kilbourn Avenue, Skokie, IL 60076 | 2018-01-22 |
| 1700335924 | Olumide Adeyemo | Nurse Practitioner | 4711 Golf Rd Suite 1250, Skokie, IL 60076 | 2016-09-28 |
| 1255705315 | Malka Rokach | Pharmacist | 3358 W Touhy, Skokie, IL 60076 | 2015-11-30 |
| 1578932620 | Katrina Margaret Keithley | Physician Assistant | 9669 Kenton Ave Ste 203, Skokie, IL 60076 | 2015-09-18 |
| Find all providers in zip 60076 | ||||
| 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 |
|---|---|---|---|---|
| 1386729408 | Joseph A Gluck | Dentist | 9933 N Lawler, 450, Skokie, IL 60077-3703 | 2006-10-26 |
| 1497842132 | David Barack | Dentist | 4905 Old Orchard Shopping Ctr, Suite 310, Skokie, IL 60077-1425 | 2006-10-06 |
| 1568478360 | Terry Annex | Dentist | 64 Old Orchard Center, Suite 616, Skokie, IL 60077-1421 | 2006-08-01 |
| 1548640485 | The Dental Specialists | Dentist | 5215 Old Orchard Rd, Suite 200, Skokie, IL 60077-1035 | 2015-06-05 |
| 1821139171 | Old Orchard Periodontics & Implant Dentistry Ltd | Dentist | 64 Old Orchard Shopping Ctr, Suite 310, Skokie, IL 60077-1425 | 2007-02-09 |
| 1275697237 | Robert A Bressman | Dentist | 9933 Lawler Ave, Suite 450, Skokie, IL 60077 | 2006-12-21 |
| 1487740494 | Robert N. Bitter | Dentist | 9933 Lawler Ave, Suite 450, Skokie, IL 60077-3703 | 2006-10-05 |
| 1265530711 | Michael Robert Oremland | Dentist | 64 Old Orchard Shopping Ctr, Suite 310, Skokie, IL 60077-1425 | 2006-09-20 |
| 1619988771 | Fred Lucas | Dentist | 9933 Lawler Ave, Skokie, IL 60077-3703 | 2006-08-11 |
| 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 | ||||
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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.