Rebecca Bosack, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.027953 Issued in IL

Practice address

16045 108TH Ave Ste a
Orland Park, IL 60467-5345

Phone

(708) 403-0005

NPI assigned

Jun 29, 2009

Sex

Female

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

Locations

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.

• Bosack Dental LLC

  • Dental Clinic/Center
  • Orland Park, IL
  • NPI 1609363589
  NPD Authorized official
• Aesthetic Dentistry, P. C.

  • General Practice Dentistry
  • Orland Park, IL
  • NPI 1689531055
  NPD (past)

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1194953265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16045 108TH AVE STE A",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675345",
            "telephone_number": "708-403-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16045 108TH AVE STE A",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675345",
            "telephone_number": "708-403-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSACK",
        "first_name": "REBECCA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-29",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.027953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Bonaminio I, BS RPH
• Nancy L Bonnevier, LCPC
• Bridget Borrelli, BCBA
• Bosack Dental LLC
• Linda Brigit Bosack, AUD
• Robert C. Bosack, DDS
• Cheryl Ann Boss, ANP-CNP
• Botti Sports & Spine
• Bryan C Bouchelion, DDS
• Firdaus Boufath

• General Practice Dentistry in Orland Park, IL
• Providers in Orland Park, 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 Dec 21, 2020; 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.