Individual provider Active NPI

Jamie Gralak, RDH

  • Dental Hygienist
  • Oak Lawn, IL
National Provider Identifier
1437508694
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
020.007849 Issued in IL
Practice address
5029 Oak Center Dr
Oak Lawn, IL 60453-3937
Phone
(773) 416-9526
NPI assigned
Jun 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 020.007849 IL Primary

Addresses

Primary practice location

5029 Oak Center Dr
Oak Lawn, IL 60453-3937

Mailing address

5029 Oak Center Dr
Oak Lawn, IL 60453-3937
Phone (773) 416-9526

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

LicenseStateTypeSpecialty
020.007849ILMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1437508694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5029 OAK CENTER DR",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533937",
            "telephone_number": "773-416-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5029 OAK CENTER DR",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533937",
            "telephone_number": "773-416-9526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRALAK",
        "first_name": "JAMIE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020.007849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.