Rekha Modur, DDS DENTISTRY

Primary specialty

DentistTaxonomy code 122300000X

License

019026099 Issued in IL

Practice address

1431 N Western Ave Ste 401
Chicago, IL 60622-7712

Phone

(773) 269-5540

NPI assigned

Mar 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1396704284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606227712",
            "telephone_number": "773-269-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 401",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606227712",
            "telephone_number": "773-269-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODUR",
        "first_name": "REKHA",
        "name_prefix": "Dr.",
        "credential": "DDS DENTISTRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32088256",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcos Modiano Esquenazi, M.D.
• Cassandra Modica, MSW
• Marcy R Modica, MPT
• Mary Ellen Modica, PT
• Modo Spira Inc.
• Catherine Moe
• Kathleen H Moe, M.D.
• Maryam Moeed, DO
• Emily Caroline Moehlmann
• Matthew Louis Moehlmann, DO

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.