Individual provider Active NPI

Ivan Valcarenghi, DDS

  • General Practice Dentistry
  • Elmhurst, IL
National Provider Identifier
1447468178
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019020242 Issued in IL
Practice address
360 W Butterfield Rd Ste 230
Elmhurst, IL 60126-5000
Phone
(630) 834-8088
NPI assigned
May 18, 2007
Last updated
May 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019020242 IL
General Practice Dentistry 1223G0001X 019020242 IL Primary

Addresses

Primary practice location

360 W Butterfield Rd Ste 230
Elmhurst, IL 60126-5000

Mailing address

360 W Butterfield Rd Ste 230
Elmhurst, IL 60126-5000
Phone (630) 834-8088

Other identifiers 1

IdentifierTypeStateIssuer
F400480643OtherMEDICARE PTAN

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
I20180702000541 IL Practitioner - Dentist 1850647074 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019020242ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Sleep Center Richard a Craig DDS LTD General Practice Current Accepting new patients
Associates for Dental Sleep Medicine, LTD Current Accepting new patients
Dental Sleep Center Richard a Craig DDS LTD General Practice CurrentSince Jun 8, 2018 Accepting new patients
Associates for Dental Sleep Medicine, LTD Dentist Current Accepting new patients

Locations

150 E Huron St
Ste 1103
Chicago, IL 60611
Phone (312) 676-9893

360 W Butterfield Rd
Ste 230
Elmhurst, IL 60126
Phone (630) 833-1800

14831 W 159th St
Ste 1
Lockport, IL 60491
Phone (312) 676-9893

2500 S Highland Ave
Ste 220
Lombard, IL 60148
Phone (630) 218-1920

120 Oakbrook Ctr
Ste 318
Oak Brook, IL 60523
Phone (630) 218-1920

220 Channahon St
Shorewood, IL 60404
Phone (630) 218-1920

4711 Golf Rd
Ste 912
Skokie, IL 60076
Phone (847) 676-3500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1447468178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD STE 230",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265000",
            "telephone_number": "630-834-8088",
            "fax_number": "630-834-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD STE 230",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265000",
            "telephone_number": "630-834-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALCARENGHI",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019020242",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019020242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400480643",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.