Jack C Yi, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019024195 Issued in IL

Practice address

3240 Vollmer Rd
Olympia Fields, IL 60461-1122

Phone

(708) 481-3866

Fax

(708) 481-8210

NPI assigned

Mar 27, 2007

Last updated

Sep 24, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• A Touch of Class Dentistry

  • Dental Clinic/Center
  • Olympia Fields, IL
  • NPI 1972812410
  NPD (past) Authorized official

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1619095593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 VOLLMER RD",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611122",
            "telephone_number": "708-481-3866",
            "fax_number": "708-481-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 VOLLMER RD",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611122",
            "telephone_number": "708-481-3866",
            "fax_number": "708-481-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "JACK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019024195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xavier Surgical Care,LLC (John J. Karl)
• Soumya Yallapragada, DO
• Scott Yasuhiro Yamashita, DO
• Aishah Asma Yanssaneh, MD
• Christian Yasmine
• Hsinyu Yin
• James E Young III, NURSE PRACTITIONER
• Your Best Behavior , LLC
• Syed Saif Zahir, D.O.
• Frhaan Zahrawi

• General Practice Dentistry in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.