Active NPI
Gregory Paul Macaluso, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Oak Brook, IL
National Provider Identifier
1417024464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 21 S907
- Practice address
- 120 Oak Brook Center Mall
Suite 608
Oak Brook, IL 60523 - Phone
- (630) 571-8393
- Fax
- (630) 571-8408
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 21 S907 | IL | Primary |
Addresses
Primary practice location
120 Oak Brook Center Mall
Suite 608
Oak Brook, IL 60523
Mailing address
120 Oak Brook Center Mall
Suite 608
Oak Brook, IL 60523
Phone (630) 571-8393
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 29, 2015 through Sep 29, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21 S907 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417024464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 OAK BROOK CENTER MALL",
"address_2": "SUITE 608",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "60523",
"telephone_number": "630-571-8393",
"fax_number": "630-571-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 OAK BROOK CENTER MALL",
"address_2": "SUITE 608",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "60523",
"telephone_number": "630-571-8393",
"fax_number": "630-571-8408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACALUSO",
"first_name": "GREGORY",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "21 S907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.