STEVEN HERZOG (NPI# 1306063631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306063631 |
| Entity Type | Individual |
| Full Name | STEVEN HERZOG |
| Credential | D.D.S., M.S. |
| Practice Address |
2440 W Peterson Ave Chicago IL 60659-4113 |
| Practice Telephone | 7737617171 |
| Practice Fax Number | 7737616714 |
| Mailing Telephone | 7737617171 |
| Mailing Fax Number | 7737616714 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2019-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
019-016111 | IL | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 019-016111 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 019016111 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4905 Old Orchard Ctr Ste 610, Skokie, IL 600771465 | 8476769303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972579449 | Steven Paul Herzog | Psychiatry & Neurology | 6080 N Central Expy Ste 100, Dallas, TX 75206-5202 | 2006-02-24 |
| Street Address |
2440 W PETERSON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60659-4113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285657833 | David S. Evaskus | Dentist | 2440 W Peterson Ave, Chicago, IL 60659-4113 | 2006-07-25 |
| 1396993945 | Michael Papadimitriou | Dentist | 2440 W Peterson Ave, Chicago, IL 60659-4113 | 2008-09-08 |
| 1316044837 | Evaskus and Herzog, Ltd | Dentist | 2440 W Peterson Ave, Chicago, IL 60659-4113 | 2006-09-19 |
| 1194833624 | Louis E Halkias | Dentist | 2440 W Peterson Ave, Chicago, IL 60659-4113 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1508410069 | Kara Lyn Anderson | Counselor | 2551 W. Peterson Ave, Chicago, IL 60659 | 2019-08-01 |
| 1568980019 | Saba Suleman | Counselor | 5815 N Spaulding Ave Apt 3a, Chicago, IL 60659 | 2017-09-05 |
| 1639695257 | Go Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5862 N Lincoln Ave, Suite 4, Chicago, IL 60659 | 2017-08-15 |
| 1972039568 | Trilogy, Inc. | Community/Behavioral Health | 2551 W Peterson Ave, Chicago, IL 60659 | 2017-05-03 |
| 1689029050 | Soulu | Voluntary or Charitable | 3557 W Peterson Ave #122, Chicago, IL 60659 | 2016-05-04 |
| 1730540550 | Michael Wei-tsi Chien | Dentist | 3425 W Peterson Ave Ste 107, Chicago, IL 60659 | 2016-03-08 |
| 1497129688 | Acquaint Homecare LLC | Home Health | 3525 West Peterson Avenue, Unit 118, Chicago, IL 60659 | 2015-11-25 |
| 1083054621 | Rebecca Schnell | Speech-Language Pathologist | 6124 N Saint Louis Ave, Chicago, IL 60659 | 2013-06-27 |
| Find all providers in zip 60659 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821652736 | Oral and Maxilloficial Head and Neck Associates LLC | Oral & Maxillofacial Surgery | 811 West Wellington Avenue, Attention: Mohammed Qaisi, Md., Dmd., Chicago, IL 60657-5123 | 2019-04-25 |
| 1295840304 | Khaled Abughazaleh | Oral & Maxillofacial Surgery | 65 E Scott St Apt 9a, Chicago, IL 60610-5274 | 2006-08-20 |
| 1518528165 | Ali Al-qudsi | Oral & Maxillofacial Surgery | 1901 W Harrison St, Chicago, IL 60612-3714 | 2019-06-25 |
| 1669033445 | Brett Quinto | Oral & Maxillofacial Surgery | 1901 W Harrison St, Chicago, IL 60612-3714 | 2019-06-24 |
| 1508144585 | James Anthony Murphy | Oral & Maxillofacial Surgery | 1969 W Ogden Ave, Chicago, IL 60612-3765 | 2011-07-25 |
| 1326338948 | Michael David Han | Oral & Maxillofacial Surgery | 801 S Paulina St, Room 110 (mc 835), Chicago, IL 60612-7210 | 2011-04-15 |
| 1881821445 | Board of Trustees of The University of Illinois | Oral & Maxillofacial Surgery | 840 S Wood St, Mc 958, Chicago, IL 60612-4325 | 2009-06-22 |
| 1225291347 | Michael Robert Markiewicz | Oral & Maxillofacial Surgery | 801 S Paulina St, Chicago, IL 60612-7210 | 2008-07-09 |
| 1992883367 | Gregory Paul Thomas | Oral & Maxillofacial Surgery | 676 N Saint Clair St, Suite 2280, Chicago, IL 60611-2927 | 2006-11-01 |
| 1659486751 | Mark B Jacob | Oral & Maxillofacial Surgery | 1740 W Taylor St, Chicago, IL 60612-7232 | 2006-08-20 |
| Find all providers in CHICAGO | ||||
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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.