Active NPI
Feross W Atallah, DMD
- Dentist
- New Lenox, IL
National Provider Identifier
1447987524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019033831
- Practice address
- 561 E Lincoln Hwy
New Lenox, IL 60451-1909 - Phone
- (708) 983-5908
- NPI assigned
- Aug 8, 2022
- Last updated
- Aug 8, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019033831 | IL | Primary |
| General Practice Dentistry | 1223G0001X | 019033831 | IL |
Addresses
Primary practice location
561 E Lincoln Hwy
New Lenox, IL 60451-1909
Mailing address
9046 Windsor Dr
Palos Hills, IL 60465-1168
Phone (708) 983-5908
Other practice location 1
590 Bankview Dr
Frankfort, IL 60423-1857
Phone (815) 469-3373
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 |
|---|---|---|---|
| 019033831 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659916800000",
"number": "1447987524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9046 WINDSOR DR",
"city": "PALOS HILLS",
"state": "IL",
"postal_code": "604651168",
"telephone_number": "708-983-5908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "561 E LINCOLN HWY",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604511909",
"telephone_number": "708-983-5908"
}
],
"practiceLocations": [
{
"address_1": "590 Bankview Dr",
"address_purpose": "LOCATION",
"city": "Frankfort",
"state": "IL",
"postal_code": "604231857",
"country_code": "US",
"telephone_number": "815-469-3373",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ATALLAH",
"first_name": "FEROSS",
"middle_name": "W",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-08",
"last_updated": "2022-08-08",
"certification_date": "2022-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019033831",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019033831",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.