Peter S. Hasiakos, D.D.S.
Individual provider Active NPI General Practice Dentistry · Countryside, IL
NPI 1467549824 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1467549824
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 475 W 55TH St
Suite #110
Countryside, IL 60525-3564 - Phone
- (708) 352-3190
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.017784 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
475 W 55TH St
Suite #110
Countryside, IL 60525-3564
Mailing address
475 W 55TH St
Suite #110
Countryside, IL 60525-3564
Phone (708) 352-3190
Other providers in Countryside, IL
- Maya Hansoti
- Elliott Hardy
- Alyssa Harkema
- Hillary Harmon
- Nolita P Hart
- Helping Hand
- Helping Hand Center
- Helping Hand Center
- Helping Hand Center
- Helping Hand Center
All providers in Countryside, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.