Individual provider Active NPI

Diyana Yonadim, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1164071486
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019032326 Issued in IL
Practice address
2155 W Roscoe St Ste 1N
Chicago, IL 60618-6261
Phone
(847) 338-4553
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019032326 IL Primary

Addresses

Primary practice location

2155 W Roscoe St Ste 1N
Chicago, IL 60618-6261

Mailing address

2228 S Elizabeth St
Lombard, IL 60148-7124
Phone (847) 338-4553

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
019032326ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1164071486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2228 S ELIZABETH ST",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601487124",
            "telephone_number": "847-338-4553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 W ROSCOE ST STE 1N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186261",
            "telephone_number": "847-338-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONADIM",
        "first_name": "DIYANA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.