Individual provider Active NPI

Jeffrey T Bonk, DDS

  • General Practice Dentistry
  • Barrington, IL
National Provider Identifier
1548300692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
525 W Old Northwest Hwy
Suite 303
Barrington, IL 60010-6814
Phone
(847) 381-3210
Fax
(847) 381-3234
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

525 W Old Northwest Hwy
Suite 303
Barrington, IL 60010-6814

Mailing address

525 W Old Northwest Hwy
Suite 303
Barrington, IL 60010-6814
Phone (847) 381-3210

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
I20110926000492 IL Practitioner - Oral Surgery 1951572817 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-017-593ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Sep 1, 2011 Accepting new patients
Loyola University Medical Center CurrentSince Sep 1, 2011 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Organizations & group practices 2

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548300692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W OLD NORTHWEST HWY",
            "address_2": "SUITE 303",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600106814",
            "telephone_number": "847-381-3210",
            "fax_number": "847-381-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W OLD NORTHWEST HWY",
            "address_2": "SUITE 303",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600106814",
            "telephone_number": "847-381-3210",
            "fax_number": "847-381-3234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONK",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

Verify at the official NPI Registry.