Individual provider Active NPI

Elliot M Razdolsky, DDS

  • Dentist
  • Buffalo Grove, IL
National Provider Identifier
1255321675
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
307 W Dundee Rd
Buffalo Grove, IL 60089-3545
Phone
(847) 353-8830
Fax
(847) 353-8841
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X IL Primary

Addresses

Primary practice location

307 W Dundee Rd
Buffalo Grove, IL 60089-3545

Mailing address

307 W Dundee Rd
Buffalo Grove, IL 60089-3545
Phone (847) 353-8830

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160212001497 IL Order and Referring Only - DentistPractitioner - Dentist 7416251368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019022520ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot M Razdolsky DDS Inc Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255321675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W DUNDEE RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600893545",
            "telephone_number": "847-353-8830",
            "fax_number": "847-353-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W DUNDEE RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600893545",
            "telephone_number": "847-353-8830",
            "fax_number": "847-353-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZDOLSKY",
        "first_name": "ELLIOT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.