PESKIN ORAL SURGERY, LTD. (NPI# 1649286287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649286287 |
| Entity Type | Organization |
| Organization Name | PESKIN ORAL SURGERY, LTD. |
| Practice Address |
4711 Golf Rd Suite 408 Skokie IL 60076-1224 |
| Practice Telephone | 8476764590 |
| Practice Fax Number | 8476764695 |
| Mailing Telephone | 8476764590 |
| Mailing Fax Number | 8476764695 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KENNETH HOWARD PESKIN (PRESIDENT/OWNER-ORAL SURGEON) |
| Authorized Official Telephone | 8476764590 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
IL | Dental Providers |
| Street Address |
4711 GOLF RD SUITE 408 |
| City | SKOKIE |
| State | IL |
| Zip Code | 60076-1224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497752893 | Alice Chen | Legal Medicine | 4711 Golf Rd, Suite 808, Skokie, IL 60076-1224 | 2005-06-30 |
| 1811418015 | Pr Orthotics & Ot LLC | Durable Medical Equipment & Medical Supplies | 4711 Golf Rd, Skokie, IL 60076-1224 | 2017-06-28 |
| 1528507548 | Elizabeth Hultman | Nurse Practitioner | 4711 Golf Rd, Skokie, IL 60076-1224 | 2017-02-23 |
| 1609314616 | Mary Lally | Behavioral Analyst | 4711 Golf Rd, Suite 100, Skokie, IL 60076-1224 | 2017-02-09 |
| 1821536822 | Steinberg Behavior Solutions | Community/Behavioral Health | 4711 Golf Rd, Suite 100, Skokie, IL 60076-1224 | 2017-02-09 |
| 1205372067 | Olasunkanmi Ogedegbe | Nurse Practitioner | 4711 Golf Rd, Suite 1250, Skokie, IL 60076-1224 | 2017-01-17 |
| 1952858409 | Marissa Bennett | Behavioral Analyst | 4711 Golf Rd, 100, Skokie, IL 60076-1224 | 2016-09-01 |
| 1326495243 | Michelle Fisher | Social Worker | 4711 Golf Rd, Suite 400, Skokie, IL 60076-1224 | 2016-05-20 |
| 1336503119 | Rebecca Arends | Counselor | 4711 Golf Rd, Suite 1200, Skokie, IL 60076-1224 | 2016-04-07 |
| 1992169015 | Jarret Helstern | Nurse Practitioner | 4711 Golf Rd, Suite 1200, Skokie, IL 60076-1224 | 2016-04-06 |
| Find all providers in the same location | ||||
| 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 | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619983244 | Kenneth Howard Peskin | Dentist | 4711 Golf Rd, Suite 408, Skokie, IL 60076-1224 | 2006-08-01 |
| 1518974773 | Sidney Peskin | Dentist | 4711 Golf Rd, Suite 408, Skokie, IL 60076-1224 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
| 1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
| 1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
| 1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
| 1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
| 1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
| 1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PESKIN ORAL SURGERY, LTD..
| 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.