Individual provider Active NPI

Maria Molnar

  • General Practice Dentistry
  • Gurnee, IL
National Provider Identifier
1417519638
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.032185 Issued in IL
Practice address
6300 Grand Ave
Gurnee, IL 60031-4538
Phone
(224) 214-4902
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.032185 IL Primary

Addresses

Primary practice location

6300 Grand Ave
Gurnee, IL 60031-4538

Mailing address

1240 W Farwell Ave
Chicago, IL 60626-3819
Phone (773) 886-9736

Other names 1

  • Maria Taralunga Other name

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
I20200206001907 IL Practitioner - Dentist 4587090774 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.032185ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake Current Accepting new patients
County of Lake CurrentSince Dec 22, 2019 Accepting new patients
County of Lake CurrentSince Dec 22, 2019 Accepting new patients

Locations

2215 Audrey Nixon Blvd
North Chicago, IL 60064
Phone (847) 377-8800

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

Interoperability endpoints

  • Direct secure messaging: maria.molnar.p1@direct.lakecountyil.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1417519638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 W FARWELL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606263819",
            "telephone_number": "773-886-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 GRAND AVE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314538",
            "telephone_number": "224-214-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLNAR",
        "first_name": "MARIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "TARALUNGA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.