Phillip M. Palella, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019026403 Issued in IL

Practice address

2037 W Division St
Chicago, IL 60622-3157

Phone

(773) 489-5700

Fax

(773) 489-5700

NPI assigned

Feb 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Modern Dental of Logan Square LLC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1639625437
  NPD (past) Authorized official
• Modern Dental on Clark Street

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1265962674
  NPD (past) Authorized official

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1063488609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223157",
            "telephone_number": "773-489-5700",
            "fax_number": "773-489-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2037 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223157",
            "telephone_number": "773-489-5700",
            "fax_number": "773-489-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALELLA",
        "first_name": "PHILLIP",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kira Lund Palazzo, MD
• Palcare Inc
• Patricia Palden
• Frank Palella, MD
• Marietta Palella, ST
• Sylvia Palella
• John Michael Palen, M.S., PH.D.
• Lira Luna Palen, AGACNP-BC
• Carlos Jose Palencia, MD
• Michelle Palenik

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.