Yan M Razdolsky, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Practice address

600 W Lake Cook Rd
Suite 150
Buffalo Grove, IL 60089-2089

Phone

(847) 215-7554

Fax

(847) 215-7563

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Michalczyk Orthodontics P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Buffalo Grove, IL
  • NPI 1356167688
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164507471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 BRAMPTON LN",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600454706",
            "telephone_number": "847-980-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W LAKE COOK RD",
            "address_2": "SUITE 150",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892089",
            "telephone_number": "847-215-7554",
            "fax_number": "847-215-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZDOLSKY",
        "first_name": "YAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priyadarsini Ramesh, M.D.
• Lizbeth Alondra Ramirez Gaytan, MASTERS OF SCIENCE
• Sam Rasty, PHARM.D., MPH
• Hannah Grace Rawhoof
• Elliot M Razdolsky, DDS
• RBG Healthcare LLC (360 Immediate Care)
• Rebecca Carter LCPC, LLC
• Efrat Rebish
• Reenvision Eyecare, S.C.
• Reflections Psychotherapy, P.C.

• Orthodontics and Dentofacial Orthopedics Dentistry in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.