Individual provider Active NPI

Fratmishin John Alexander, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1104864297
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
6408 N California Ave
Chicago, IL 60645-5209
Phone
(773) 338-6565
Fax
(773) 338-6552
NPI assigned
Jun 2, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

6408 N California Ave
Chicago, IL 60645-5209

Mailing address

6408 N California Ave
PO Box 597770
Chicago, IL 60645-5209
Phone (773) 338-6565

Other identifiers 1

IdentifierTypeStateIssuer
1001041MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151230001359 IL Order and Referring Only - DentistPractitioner - Dentist 5496057945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019019290ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fratmishin J. Alexander Current Accepting new patients

Locations

6408 N California Ave
Chicago, IL 60645
Phone (773) 338-6565

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104864297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6408 N CALIFORNIA AVE",
            "address_2": "PO BOX 597770",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455209",
            "telephone_number": "773-338-6565",
            "fax_number": "773-338-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 N CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455209",
            "telephone_number": "773-338-6565",
            "fax_number": "773-338-6552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "FRATMISHIN",
        "middle_name": "JOHN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001041",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.