Individual provider Active NPI

Akhila Cyriac, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1619640760
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019033320 Issued in IL
Practice address
7037 S Stony Island Ave
Chicago, IL 60649-1905
Phone
(312) 996-2000
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019033320 IL Primary

Addresses

Primary practice location

7037 S Stony Island Ave
Chicago, IL 60649-1905

Mailing address

8422 W Johanna Dr
Niles, IL 60714-1851

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
I20230821002130 IL Practitioner - Dentist 2860854064 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 8, 2023 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 8, 2023 Accepting new patients
Ora Dental Studio, River North Dentist PastSince Jan 1, 2023 Accepting new patients

Locations

1220 S Wood St
Chicago, IL 60608
Phone (312) 413-1261

7037 S Stony Island Ave
Chicago, IL 60649
Phone (312) 355-5590

7702 Solution Ctr
Chicago, IL 60677

Organizations & group practices 4

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1619640760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8422 W JOHANNA DR",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7037 S STONY ISLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606491905",
            "telephone_number": "312-996-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYRIAC",
        "first_name": "AKHILA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019033320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.