Individual provider Active NPI

John Christopher Neis, DMD

  • General Practice Dentistry
  • Melrose Park, IL
National Provider Identifier
1497277974
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.031254 Issued in IL
Practice address
3521 W Lake St
Melrose Park, IL 60160-2825
Phone
(708) 865-1214
NPI assigned
Jul 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 019.031254 IL Primary

Addresses

Primary practice location

3521 W Lake St
Melrose Park, IL 60160-2825

Mailing address

1275 W Lake St Apt 304
Addison, IL 60101-5762
Phone (630) 212-7298

Other practice location 1

545 S York Rd Ste 200
Bensenville, IL 60106-3000
Phone (630) 766-0115

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
019.031254ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
William J. Wash DDS LTD. General Practice Past Accepting new patients
Prosperritta Dental, PLLC General Practice PastSince Dec 21, 2021 Accepting new patients
George D Di Tola DDS LTD Past Accepting new patients

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497277974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 W LAKE ST APT 304",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015762",
            "telephone_number": "630-212-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 W LAKE ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602825",
            "telephone_number": "708-865-1214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 S York Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bensenville",
            "state": "IL",
            "postal_code": "601063000",
            "country_code": "US",
            "telephone_number": "630-766-0115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEIS",
        "first_name": "JOHN",
        "middle_name": "CHRISTOPHER",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.