Alex Hutnik I

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-029921 Issued in IL

Practice address

809 W Detweiller Dr
Suite 805a
Peoria, IL 61615-2149

Phone

(309) 692-1320

Fax

(309) 692-1355

NPI assigned

Jul 14, 2014

Last updated

Jul 14, 2014By the provider in NPPES

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

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aesthetic Dentistry of Frankfort, P.C.

  • General Practice Dentistry
  • Frankfort, IL
  • NPI 1518817824
  NPD
• Orland Park Dental Services

  • General Practice Dentistry
  • Peoria, IL
  • NPI 1215107966
  NPD (past)

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1073920997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17748 WESTBROOK DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678552",
            "telephone_number": "708-703-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W DETWEILLER DR",
            "address_2": "SUITE 805A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152149",
            "telephone_number": "309-692-1320",
            "fax_number": "309-692-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTNIK",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-029921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019029921",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyssa M Huschen, OTR/L
• Asya Yasmine Hussain, MD
• Nooreen Hussain, DO
• Taylor Marie Hutchcraft, BACHELORS
• Julia Hutchison, D.O.
• Charlotte Hutsell, CRNA
• Paul D Hutsell, CRNA
• Madison Hutson
• Karen Ann Hutton, RD, LDN, MA
• Amy Huynh

• General Practice Dentistry in Peoria, IL
• Providers in Peoria, 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 Jul 14, 2014; 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.