JACK KOU (NPI# 1295094563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295094563 |
| Entity Type | Individual |
| Full Name | JACK KOU |
| Credential | D.D.S. |
| Practice Address |
3020 S Cicero Ave Cicero IL 60804-3638 |
| Mailing Address |
1938 S Prairie Ave Chicago IL 60616-1321 |
| Practice Telephone | 7088632000 |
| Mailing Telephone | 7342777433 |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2017-02-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 019029583 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 019029583 | 05 |
| Street Address |
3020 S CICERO AVE |
| City | CICERO |
| State | IL |
| Zip Code | 60804-3638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295935369 | Sinan A Razzak | Dentist | 3020 S Cicero Ave, Cicero, IL 60804-3638 | 2007-07-18 |
| 1770141426 | Dina Alqawasma | Dentist | 3020 S Cicero Ave, Cicero, IL 60804-3638 | 2019-05-29 |
| 1881169134 | Braces Town PC | Clinic/Center | 3020 S Cicero Ave, Cicero, IL 60804-3638 | 2018-10-12 |
| 1063789584 | Image Dental LLC | Dentist | 3020 S Cicero Ave, Cicero, IL 60804-3638 | 2011-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265096945 | Jacqueline N/a Gonzalez | Physical Therapy Assistant | 3521 S 56th Ct, Cicero, IL 60804 | 2019-04-27 |
| 1265966832 | Jacqueline Calles | Substance Abuse Rehabilitation Facility | 4904 W. 32nd St, Cicero, IL 60804 | 2017-04-20 |
| 1346667771 | America's Best Contacts & Eyeglasses | Technician/Technologist | 4741 W Cermak Rd, Cicero, IL 60804 | 2014-03-24 |
| 1538580469 | Jesus Paul Sanchez | Behavioral Analyst | 3100 S. Central Ave, Cicero, IL 60804 | 2013-12-19 |
| 1568712123 | Monil P Shah Dmd PC | Dentist | 5539 W Cermak Road, Cicero, IL 60804 | 2012-09-11 |
| 1699073148 | Lolita Aguinaga | Social Worker | 5341 W. Cermak Road, Cicero, IL 60804 | 2011-03-08 |
| 1699949263 | Anne T Gearhart | Pediatrics | 2307 S Cicero Ave, Chicago, IL 60804 | 2008-04-15 |
| 1437332467 | J S Vitamins and More Inc | Durable Medical Equipment & Medical Supplies | 4785 W Cermatz, Circero, IL 60804 | 2007-12-13 |
| 1427171339 | Barbara J Majchrowski | Optometrist | 5729 W 35th Street, Suite 1east, Cicero, IL 60804 | 2007-04-06 |
| 1124190269 | Gulliume Moor | Psychologist | 6117 West Cermak Road, Cicero, IL 60804 | 2006-11-14 |
| Find all providers in zip 60804 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356837512 | Jennifer Lonnen Dds Pllc | Dentist | 6221 Rt 31 Ste 102, Cicero, NY 13039 | 2018-07-10 |
| 1386090397 | Kristin Raineri | Dentist | 5972 Rt 31, Cicero, NY 13039 | 2016-05-09 |
| 1982942124 | Seada G. Damiano | Dentist | 5972 State Route 31, Cicero, NY 13039-8941 | 2013-01-23 |
| 1982956249 | Sby Dds PC | Dentist | 5315 W Cermak Rd, Cicero, IL 60804-2817 | 2012-10-11 |
| 1194976282 | Perfect Dental Smile, Ltd | Dentist | 6017 W Cermak Rd, Cicero, IL 60804-2018 | 2008-10-07 |
| 1295935369 | Sinan A Razzak | Dentist | 3020 S Cicero Ave, Cicero, IL 60804-3638 | 2007-07-18 |
| 1942421292 | Daniel Quiros | Dentist | 6195 State Route 31, Suite 10, Choice Family Dentistry & Dentures, Cicero, NY 13039 | 2007-05-02 |
| 1548486905 | Mark R Montgomery | Dentist | 130 W Jackson St, Cicero, IN 46034 | 2007-04-17 |
| 1699820837 | Sherin B Jacob | Dentist | 4939 W 14th St, Cicero, IL 60804-1419 | 2007-01-25 |
| 1073668380 | Amee Soni | Dentist | 5539 W Cermak Rd, Cicero, IL 60804-2218 | 2007-01-24 |
| Find all providers in CICERO | ||||
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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.