Steven Herzog, D.D.S., M.S.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

019-016111 Issued in IL

Practice address

2440 W Peterson Ave
Chicago, IL 60659-4113

Phone

(773) 761-7171

Fax

(773) 761-6714

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Evaskus and Herzog, LTD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Chicago, IL
  • NPI 1316044837

  Oral and Maxillofacial Surgery

  Medicare reassignment NPD

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1306063631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594113",
            "telephone_number": "773-761-7171",
            "fax_number": "773-761-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594113",
            "telephone_number": "773-761-7171",
            "fax_number": "773-761-6714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4905 Old Orchard Ctr Ste 610",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600771465",
            "country_code": "US",
            "telephone_number": "847-676-9303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERZOG",
        "first_name": "STEVEN",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019-016111",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "019-016111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019016111",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Irene Herzer, D.C.
• Devon Max Herzoff, LCSW
• Malcolm Dugro Herzog, D.P.M.
• Martha L. Herzog, RN BSN
• Michelle Herzog, LMFT, CST
• Katie Hesch
• George Heseqial, PHARMD
• Tracy Heskett
• Caroline Strafford Hesko, M.D
• Aimee K Heslop, DPT

• Oral & Maxillofacial Surgery (D.M.D.) in Chicago, IL
• Providers in Chicago, IL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.