Active NPI
Rami Mikati
- Pediatric Dentistry
- Chicago, IL
National Provider Identifier
1285096867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 021002918
- Practice address
- 2959 S Wallace St
Chicago, IL 60616-3034 - Phone
- (312) 326-5437
- NPI assigned
- Mar 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 021002918 | IL | Primary |
Addresses
Primary practice location
2959 S Wallace St
Chicago, IL 60616-3034
Mailing address
1249 W Madison St Unit 305
Chicago, IL 60607-1521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 1, 2019 through Aug 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021002918 | IL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561939200000",
"number": "1285096867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1249 W MADISON ST UNIT 305",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606071521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2959 S WALLACE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606163034",
"telephone_number": "312-326-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKATI",
"first_name": "RAMI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-23",
"last_updated": "2019-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "021002918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.