Active NPI
Leona Dalia Petreikis, DDS
- Dentist
- Hickory Hills, IL
National Provider Identifier
1396910147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019017254
- Practice address
- 9055 S Roberts Road
Hickory Hills, IL 60457-3812 - Phone
- (708) 598-4055
- Fax
- (708) 598-0079
- NPI assigned
- Apr 23, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019017254 | IL | Primary |
Addresses
Primary practice location
9055 S Roberts Road
Hickory Hills, IL 60457-3812
Mailing address
9055 S Roberts Road
Hickory Hills, IL 60457-3812
Phone (708) 598-4055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019017254 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1396910147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9055 S ROBERTS ROAD",
"city": "HICKORY HILLS",
"state": "IL",
"postal_code": "604573812",
"telephone_number": "708-598-4055",
"fax_number": "708-598-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9055 S ROBERTS ROAD",
"city": "HICKORY HILLS",
"state": "IL",
"postal_code": "604573812",
"telephone_number": "708-598-4055",
"fax_number": "708-598-0079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETREIKIS",
"first_name": "LEONA",
"middle_name": "DALIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-23",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019017254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hickory Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.