Illinois Dental Providers (Harlem & North), LTD.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

ILLINOIS DENTAL PROVIDERS (HARLEM & NORTH), LTD.

Practice address

7235 Madison St
Forest Park, IL 60130-1764

Phone

(708) 405-9344

Fax

(216) 584-1016

NPI assigned

Feb 11, 2006

Organization subpart

Yes

Parent organization

DENTALONE PARTNERS, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rachel Nittinger

Title

Manager Credentialing

Phone

(972) 755-0816

Specialties & licenses 9

Addresses

Other names 1

• DentalWorks of Forest Park Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Faisal Saadoon

  • General Practice Dentistry
  • Forest Park, IL
  • NPI 1477284354
  NPD (past)
• Ahmed Sammy, DDS

  • General Practice Dentistry
  • Kennesaw, GA
  • NPI 1508350257
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1013980705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 DALLAS PKWY STE 400",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750247111",
            "telephone_number": "972-755-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7235 MADISON ST",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301764",
            "telephone_number": "708-405-9344",
            "fax_number": "216-584-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DENTAL PROVIDERS (HARLEM & NORTH), LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTALONE PARTNERS, INC",
        "enumeration_date": "2006-02-11",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "NITTINGER",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "MANAGER CREDENTIALING",
        "authorized_official_telephone_number": "972-755-0816"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.022557",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DentalWorks of Forest Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DentalWorks of Forest Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Therese Ann Hogg, LPC
• Jessica Huerta, LCPC
• Maureen Hurley
• Huma Hussain, OD
• Illinois Behavior Analysis Group, LLC
• Isa'S Creative Counseling
• Jessica Jacknow
• Marvin Zebedee Jackson Jr., B.S.,D.C.
• Karen Janiec, NP
• Jayreese Transportation Service

• Dentist in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.