Mikhail Korolyov, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019030293 Issued in IL

Practice address

6554 W Higgins Ave
Chicago, IL 60656-2161

Phone

(773) 736-5151

NPI assigned

Jul 28, 2015

Last updated

Jul 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1295110500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6554 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606562161",
            "telephone_number": "773-736-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6554 W HIGGINS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606562161",
            "telephone_number": "773-736-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLYOV",
        "first_name": "MIKHAIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019030293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kornfeld, MD
• Sarena Arlene Korni, LCPC
• Lisa M Kornita, DPT
• Victoria Alexandra Korol, DMD
• Jamie Ann Korolyov, D.M.D.
• Banio P Koroma, MD
• Michael James Koronkowski, PHARM.D.
• Michalina Christina Koronkowski
• Jenifer Corinne Korotko, LCPC
• Kirill Korotkov

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, 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 Jul 28, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.