Individual provider Active NPI

Hrisoula Psikos

  • Dentist
  • Chicago, IL
National Provider Identifier
1366685679
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019023412 Issued in IL
Practice address
3334 N Central Ave
Chicago, IL 60634-4411
Phone
(773) 725-5600
NPI assigned
Apr 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019023412 IL Primary

Addresses

Primary practice location

3334 N Central Ave
Chicago, IL 60634-4411

Mailing address

3334 N Central Ave
Chicago, IL 60634-4411
Phone (773) 725-5600

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
I20160523002711 IL Order and Referring Only - DentistPractitioner - Dentist 3375832850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019023412ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1366685679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344411",
            "telephone_number": "773-725-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 N CENTRAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344411",
            "telephone_number": "773-725-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSIKOS",
        "first_name": "HRISOULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019023412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.