Suzanne M Bono, DDS
Individual provider Active NPI General Practice Dentistry · Niles, IL
NPI 1093864530 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1093864530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 8747 N Oketo Ave
Niles, IL 60714-2068 - Phone
- (847) 966-4566
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151014000713 | IL | Order and Referring Only - Dentist |
7113236126 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
8747 N Oketo Ave
Niles, IL 60714-2068
Mailing address
8747 N Oketo Ave
Niles, IL 60714-2068
Phone (847) 966-4566
Other providers in Niles, IL
- Nida B Blankas Hernaez
- Bloom & Balance, PLLC
- Jacob Raymond Boneck
- Megan Bonis
- Jennifer Bonk
- Maria Andreea Bordeianu
- Marina Borochin
- Noemi N Borrillo
- Simon Boyarskiy
- Catherine Brasic
All providers in Niles, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.