Active NPI
Michelle N Zmick, D.D,S,
- Periodontics
- Long Grove, IL
National Provider Identifier
1114044526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 021-1093
- Practice address
- 5246 RFD
Long Grove, IL 60047-9794 - Phone
- (847) 821-1696
- Fax
- (847) 821-1875
- NPI assigned
- Mar 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-0016706 | IL | |
| Periodontics | 1223P0300X | 021-1093 | IL | Primary |
Addresses
Primary practice location
5246 RFD
Long Grove, IL 60047-9794
Mailing address
5246 RFD
Long Grove, IL 60047-9794
Phone (847) 821-1696
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150521000257 | IL | Order and Referring Only - Oral Surgery | 1153641899 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-0016706 | IL | MD | Dentist |
| 021-1093 | IL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1114044526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5246 RFD",
"city": "LONG GROVE",
"state": "IL",
"postal_code": "600479794",
"telephone_number": "847-821-1696",
"fax_number": "847-821-1875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5246 RFD",
"city": "LONG GROVE",
"state": "IL",
"postal_code": "600479794",
"telephone_number": "847-821-1696",
"fax_number": "847-821-1875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZMICK",
"first_name": "MICHELLE",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "D.D,S,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-0016706",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IL",
"license": "021-1093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.