DR. MARYLENE VITIELLO (NPI# 1538558408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538558408 |
| Entity Type | Individual |
| Full Name | DR. MARYLENE VITIELLO |
| Credential | DDS |
| Practice Address |
1525 E 55th St Ste 303 Chicago IL 60615 |
| Mailing Address |
1525 E 55th St Ste 303 Chicago IL 60615-5512 |
| Practice Telephone | 7739479994 |
| Practice Fax Number | 7739478281 |
| Mailing Telephone | 7739479994 |
| Mailing Fax Number | 7739478281 |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2018-05-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 021001441 | IL | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
021001441 | IL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2069 N Clybourn Ave, Chicago, IL 606144003 | 7733273331 |
| Street Address |
1525 E 55TH ST STE 303 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170221 | Cook County | Technician, Other | 430 East 51st Pl, Chicago, IL 60615 | 2020-09-28 |
| 1700498326 | Connie Frances Davis | Massage Therapist | 5481 S. Cornell, Chicago, IL 60615 | 2020-08-17 |
| 1134781974 | Lifestyle Rejuvenation Medical Group Pllc | Chiropractor | 1740 E 55th Street, Chicago, IL 60615 | 2019-07-02 |
| 1275007767 | Michelle Alyse Costello | Social Worker | 1225 E 53rd St, Suite 606, Chicago, IL 60615 | 2019-01-17 |
| 1194207522 | Cindy Louise Lys | Social Worker | 1525 E 53rd Street Suite 516-4, Chicago, IL 60615 | 2018-09-01 |
| 1861983660 | Pranusha Pinna | Student in an Organized Health Care Education/Training Program | 1850 W. Harrison St., Chicago, IL 60615 | 2018-05-29 |
| 1528577632 | Jonah Waseberg | Counselor | 1100 E.55th St, Chicago, IL 60615 | 2017-09-21 |
| 1710404496 | Tawann Jackson | Psychologist | 360 Blair Lane, Door 13, Bolingbrook, IL 60615 | 2017-08-24 |
| 1194259069 | Molly Kachale Netter | Nurse Practitioner | 1554 E 55th St., Chicago, IL 60615 | 2017-04-17 |
| 1205387990 | Kirk Remon Riddle | Counselor | 1525 E. 53rd Street, Suite 425, Chicago, IL 60615 | 2016-10-18 |
| Find all providers in zip 60615 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| 1811300437 | Michaella Radich Heitzler | Dentist | 1611 N. Wolcott Ave, Chicago, IL 60622 | 2014-06-11 |
| 1356768030 | Esther Levine Pincus | Dentist | Chicago Dental Professionals, 2340 North Clybourn Avenue, Chicago, IL 60614 | 2014-03-19 |
| 1316382187 | Serena Mitchual | Dentist | 801 S Paulina St Rm 256, Chicago, IL 60612-7210 | 2013-05-07 |
| 1962790428 | Megan Davenport | Dentist | 1611 N. Wolcott Ave., Chicago, IL 60622-1362 | 2011-07-19 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| 1013147024 | Yummy Dental | Dentist | 3500 N Lincoln Ave, Chicago, IL 60657-1104 | 2009-07-24 |
| 1659513950 | Melissa Marie Connell | Dentist | 1611 Wolcott Ave., Chicago, IL 60622 | 2009-04-01 |
| 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.