Individual provider Active NPI

Alan Esha Shlimon

  • Dentist
  • Chicago, IL
National Provider Identifier
1255650354
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028272 Issued in IL
Practice address
5400 N Milwaukee Ave
Chicago, IL 60630-1272
Phone
(312) 388-2526
Fax
(773) 696-9110
NPI assigned
May 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019028272 IL Primary

Addresses

Primary practice location

5400 N Milwaukee Ave
Chicago, IL 60630-1272

Mailing address

1815 Balmoral CT
Glendale Heights, IL 60139-1307
Phone (312) 388-2526

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
I20151204002180 IL Order and Referring Only - DentistPractitioner - Dentist 9638479231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019028272ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Legend Dental 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": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1255650354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 BALMORAL CT",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391307",
            "telephone_number": "312-388-2526",
            "fax_number": "773-696-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301272",
            "telephone_number": "312-388-2526",
            "fax_number": "773-696-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLIMON",
        "first_name": "ALAN",
        "middle_name": "ESHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.