ANN FREDERICKSON (NPI# 1073122016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073122016 |
| Entity Type | Individual |
| Full Name | ANN FREDERICKSON |
| Credential | RDH, BSDH |
| Practice Address |
9851 S Homan Ave Evergreen Park IL 60805-3041 |
| Practice Telephone | 7082038046 |
| Mailing Telephone | 7082038046 |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 020.009503 | IL | Dental Providers |
| Street Address |
9851 S HOMAN AVE |
| City | EVERGREEN PARK |
| State | IL |
| Zip Code | 60805-3041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254603 | Cynthia Nicole Bucio | Pharmacist | 9400 S. Western, Evergreen Park, N/A 60805 | 2020-10-27 |
| 1124530456 | Foundations Counseling, LLC | Social Worker | 9730 S Western Ave Ste 215, Evergreen Park, IL 60805 | 2017-10-26 |
| 1184147886 | Luke Blaeser | Specialist/Technologist | 2856 W. 97th Pl., Evergreen Park, IL 60805 | 2017-07-25 |
| 1396193322 | Daniel Joseph Bierbaum Howard | Emergency Medicine | 2800 95th St, Emergency Department, Evergreen Park, IL 60805 | 2016-05-31 |
| 1588037873 | Lcr Primary Care LLC | Exclusive Provider Organization | 9237 S.pulaski, Ste. 2s, Evergreen Park, IL 60805 | 2015-11-09 |
| 1447639091 | Nancy Sanchez | Social Worker | 9832 S Utica Ave, Evergreen Park, IL 60805 | 2015-05-28 |
| 1629334743 | Harshad M. Mehta Md Sc | Psychiatry & Neurology | 2850 W. 95th Street, Suite 206, Evergreen Park, IL 60805 | 2012-04-03 |
| 1235407305 | Victoria T Adesina | Pharmacist | 8700 South Kedzie Ave, Evergreen Park, IL 60805 | 2011-12-05 |
| 1891072922 | Zahia-lena Refat Hussien | Pharmacist | 8700 S. Kedzie Ave, Evergreen Park, IL 60805 | 2011-11-03 |
| 1891079091 | Denise Adams | Occupational Therapy Assistant | 9217 S. Kedzie, Evergreen Park, IL 60805 | 2011-10-06 |
| Find all providers in zip 60805 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912379017 | Iyad S Omar | Dental Hygienist | 2803 W 95th St, Evergreen Park, IL 60805-2702 | 2015-10-28 |
| 1023242872 | Jennifer Lindsay Czerwien | Dental Hygienist | 2803 W 95th St, Evergreen Park, IL 60805-2702 | 2009-05-08 |
| 1932349966 | Kandyce Lynze Green | Dental Hygienist | 2803 W 95th St, Evergreen Park, IL 60805-2702 | 2009-03-04 |
| 1164604740 | Dimitra Petrakos | Dental Hygienist | 2803 W 95th St, Evergreen Park, IL 60805-2702 | 2007-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457950891 | Laura Jean Baus | Dental Hygienist | 519 E Bode Rd, Streamwood, IL 60107-6897 | 2020-10-17 |
| 1972114551 | Chelsea R Black | Dental Hygienist | 428 N 8th St, Auburn, IL 62615-1006 | 2020-08-16 |
| 1912518150 | Nicole Lynn Connell | Dental Hygienist | 204 Hwy 164 East, Oquawka, IL 61469 | 2020-08-12 |
| 1588289805 | Joy Lantz | Dental Hygienist | 16335 Harlem Ave Ste 422, Tinley Park, IL 60477-2877 | 2020-06-11 |
| 1740805381 | Goran Lazic | Dental Hygienist | 109 Annapolis Dr, Vernon Hills, IL 60061-2057 | 2020-06-09 |
| 1568085991 | Amy Lappin | Dental Hygienist | 335 Hidden Creek Rd, Lake Zurich, IL 60047-7116 | 2020-05-20 |
| 1114540630 | Krista M Walsh | Dental Hygienist | 890 Brookforest Ave Unit D, Shorewood, IL 60404-8838 | 2020-05-19 |
| 1881214658 | Sherri Foran | Dental Hygienist | 127 60th St, Downers Grove, IL 60516-2038 | 2020-04-22 |
| 1124666573 | Katherine Lynn Leiva | Dental Hygienist | 1791 Dempsey Cir, Pingree Grove, IL 60140-8019 | 2019-12-17 |
| 1417504192 | Laura M Scully | Dental Hygienist | 7013 W Farragut Ave, Chicago, IL 60656-1923 | 2019-08-19 |
| Find all providers with the same taxonomy | ||||
| City | EVERGREEN PARK |
| Zip Code | 60805 |
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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.