William G Mitsos, DDS

Primary specialty

DentistTaxonomy code 122300000X

Practice address

1291 S Seventh Ave
Kankakee, IL 60901

Phone

(815) 932-0022

Fax

(815) 932-1202

NPI assigned

Sep 27, 2007

Sex

Male

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

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.

• William Mitsos DDS

  • Dentist
  • Kankakee, IL
  • NPI 1558978841
  NPD (past) Authorized official

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1194912709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 S SEVENTH AVE",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "60901",
            "telephone_number": "815-932-0022",
            "fax_number": "815-932-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 S SEVENTH AVE",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "60901",
            "telephone_number": "815-932-0022",
            "fax_number": "815-932-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSOS",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan B Miller, D.O.
• Kyle L Miller, PHARMD
• Holly Joann Milton
• Misbah Uddin Ahmed MD SC
• John A Mitchell, MD
• Patrick Ndibe Mogbo, PHARM.D.
• Moments Hospice of Kankakee LLC
• Adam Joseph Moody, PTA
• Timothy Moran, M.D.
• Douglas Jay Morr, MD

• Dentist in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.