Susan K. Zelazo-Smith, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019020728 Issued in IL

Practice address

5911 W 63Rd St
Chicago, IL 60638-5409

Phone

(773) 284-7149

NPI assigned

Aug 20, 2007

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1164615647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606385409",
            "telephone_number": "773-284-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606385409",
            "telephone_number": "773-284-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELAZO-SMITH",
        "first_name": "SUSAN",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ross Scott Zeitlin
• Linda Beth Zekas, APN
• Tyler M Zeken, DPT
• Frances Rose Zekiri, L. AC.
• Klaudia Zelazko
• Peter Zeldow, PHD
• Tiffany Zelek, LCSW
• Amber Zelem
• Marta Zelena, PA-C
• Brett Ryan Zelencik, LCPC, LPC, LMHC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.

Verify at the official NPI Registry.