WILLIS ABT DENTAL PRACTICE (NPI# 1689765679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689765679 |
| Entity Type | Organization |
| Organization Name | WILLIS ABT DENTAL PRACTICE |
| Other Organization Name | PAUL WILLIS DDS ELLIOT ABT DDS MS RANDALL HIRSCH DDS |
| Practice Address |
4709 Golf Road Suite 1005 2 Concourse Office Plaza Skokie IL 60076 |
| Practice Telephone | 8476772404 |
| Practice Fax Number | 8476777432 |
| Mailing Telephone | 8476772404 |
| Mailing Fax Number | 8476777432 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ELLIOT ABT (DENTIST PARTNER) |
| Authorized Official Telephone | 8471772404 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Paul Willis DDS Elliot Abt DDS MS Randall Hirsch DDS | Other Name - Individual/Organization |
| Street Address |
4709 GOLF ROAD SUITE 1005 2 CONCOURSE OFFICE PLAZA |
| City | SKOKIE |
| State | IL |
| Zip Code | 60076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104866946 | Edward Spencer Landreth | Psychologist | 4709 Golf Road, Suite 1150, Skokie, IL 60076-1252 | 2006-06-08 |
| 1891843983 | Catherine Ann Kieft | Psychologist | 4709 Golf Road, Suite 1150, Skokie, IL 60076-1252 | 2007-01-08 |
| 1164535845 | Mark J Landau Dds Ltd | Dentist | 4709 Golf Road, Suite 809, Skokie, IL 60076 | 2006-08-16 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972068062 | Brighter Smile Dentistry, P.C. | Dentist | 4836 Main St Ste 1, Skokie, IL 60077-2594 | 2019-02-04 |
| 1093219784 | Joan C Wang | Dentist | 4709 Golf Rd Ste 804, Skokie, IL 60076-1258 | 2018-03-19 |
| 1659816155 | Village Crossing Dentistry Ltd | Dentist | 7133 Central Ave, Skokie, IL 60077-3275 | 2016-12-20 |
| 1992151518 | Lavi Zaret | Dentist | 4711 Golf Rd Ste 550, Skokie, IL 60076-1269 | 2016-05-12 |
| 1720497266 | University Dental Associates | Dentist | 5215 Old Orchard Rd Ste 200, Skokie, IL 60077-1041 | 2014-08-08 |
| 1629203302 | Mengyu Tsai Dds Ltd | Dentist | 9530 Lowell Ave, Skokie, IL 60076-1465 | 2009-05-24 |
| 1154555142 | Jessie Kunnel | Dentist | 9933 Lawler Ave Ste 401, Skokie, IL 60077-3726 | 2009-05-06 |
| 1679707616 | Asher S Gelman | Dentist | 9138 Four Winds Way, Skokie, IL 60076-1753 | 2009-05-05 |
| 1255590030 | Douglas R. Hasegawa | Dentist | 3347 Dempster St, Skokie, IL 60076-2411 | 2008-06-05 |
| 1679740534 | Constantin Izvanariu | Dentist | 7514 Skokie Blvd, Skokie, IL 60077-3377 | 2008-05-09 |
| Find all providers in SKOKIE | ||||
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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.