NPIMap

Organization Active NPI

Premier Dental Care Illinois Inc

  • Dental Clinic/Center
  • Evanston, IL
National Provider Identifier
1255985669
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PREMIER DENTAL CARE ILLINOIS INC
Practice address
1819 Church St
Evanston, IL 60201-3415
Phone
(847) 866-7430
NPI assigned
Jul 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Hidayathulla KhanNPI 1699128082
Title
Owner
Phone
(224) 443-4988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1819 Church St
Evanston, IL 60201-3415

Mailing address

1819 Church St
Evanston, IL 60201-3415
Phone (847) 866-7430

National Provider Directory

National Provider Directory

Locations

1819 Church St
Evanston, IL 60201
Phone (847) 866-7430

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1255985669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 CHURCH ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013415",
            "telephone_number": "847-866-7430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 CHURCH ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013415",
            "telephone_number": "847-866-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL CARE ILLINOIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "HIDAYATHULLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-443-4988"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.