| NPI | 1245741578 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2017-10-13 |
| Last Updated | 2017-10-13 |
| Authorized Official | Rostislav Krasnov owner Phone: 7864757600 |
| Mailing Address | 7501 W Cermak Rd Ste F16 North Riverside, IL 60546-2815 United States Phone: (708) 402-8001 📍 View Map |
| Primary Practice Address | 7501 W Cermak Rd Ste F16 North Riverside, IL 60546-2815 United States Phone: (708) 402-8001 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 122300000X – Dentist | IL | - |
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About NPI 1245741578
Chicago Mall Dental Associates, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1245741578. The primary specialty listed is Dentist. The organization is located in North Riverside, IL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2017-10-13. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1245741578?
NPI 1245741578 belongs to Chicago Mall Dental Associates, Llc, a Dentist in North Riverside, IL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1245741578 active?
The current status of NPI 1245741578 in the NPPES registry is Active. The record was last updated on 2017-10-13.
What specialty is NPI 1245741578?
NPI 1245741578 is classified under the taxonomy Dentist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1245741578?
You can verify NPI 1245741578 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1245741578?
The primary practice address on file for NPI 1245741578 is 7501 W Cermak Rd Ste F16, North Riverside, IL 60546-2815. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1245741578 issued?
NPI 1245741578 was first issued (enumerated) on 2017-10-13. The NPPES record was last updated on 2017-10-13.
Practice Location Map
Chicago Mall Dental Associates, Llc is located at 7501 W Cermak Rd Ste F16, North Riverside, IL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Chicago Mall Dental Associates, Llc. All records sourced from the CMS NPPES registry.