Individual provider Active NPI

Jessie Kunnel, D.D.S

  • General Practice Dentistry
  • Skokie, IL
National Provider Identifier
1154555142
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019024836 Issued in IL
Practice address
9933 Lawler Ave Ste 401
Skokie, IL 60077-3726
Phone
(847) 675-5590
NPI assigned
May 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 019024293 IL
General Practice Dentistry 1223G0001X 019024836 IL Primary

Addresses

Primary practice location

9933 Lawler Ave Ste 401
Skokie, IL 60077-3726

Mailing address

9933 Lawler Ave Ste 401
Skokie, IL 60077-3726
Phone (847) 675-5590

Other practice location 1

2537 W North Ave
Melrose Park, IL 60160-1121
Phone (708) 345-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019024836ILMDGeneral Practice Dentistry
019024293ILMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Experts, LLC General Practice Past Accepting new patients
Kunnel Dental Center P.C. Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1154555142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 401",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773726",
            "telephone_number": "847-675-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 401",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773726",
            "telephone_number": "847-675-5590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2537 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Melrose Park",
            "state": "IL",
            "postal_code": "601601121",
            "country_code": "US",
            "telephone_number": "708-345-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUNNEL",
        "first_name": "JESSIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019024293",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019024836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.