Periodontics LTD.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PERIODONTICS LTD.

Practice address

4711 Golf Rd Ste 101
Skokie, IL 60076-1239

Phone

(847) 675-7555

Fax

(847) 675-3734

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephen P Russo, DMD

Title

Partner

Phone

(847) 675-7555

Specialties & licenses 1

Addresses

Tax ID family

Periodontics LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Periodontics LTD.

  • Periodontics
  • Chicago, IL
  • NPI 1336219856
  NPD tax ID

Locations

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043344492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 101",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761239",
            "telephone_number": "847-675-7555",
            "fax_number": "847-675-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 101",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761239",
            "telephone_number": "847-675-7555",
            "fax_number": "847-675-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTICS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "847-675-7555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronit Emunah Peikes, LCSW
• Kate Pellish
• Michele Penaflorida
• Mark Anthony De Castro Penarroyo
• Ludmila Perciun
• Jeannette Rebecca Perkal, MAAT, LPC
• Judith Lea Perlman, M.S.W.
• Blair Valentine Person, M.S., CCC-SLP
• Peskin Oral Surgery, LTD.
• Kenneth Howard Peskin, D.D.S.

• Periodontics in Skokie, IL
• Providers in Skokie, IL by specialty
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.