Dentistryone of Illinois PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTISTRYONE OF ILLINOIS PC

Practice address

2515 Waukegan Rd # 557
Bannockburn, IL 60015-1569

Phone

(877) 712-7875

NPI assigned

Jan 17, 2024

Last updated

May 2, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek Weigand

Title

Owner

Phone

(877) 712-7875

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1619738796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HIGHLAND AVE",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088401949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 WAUKEGAN RD # 557",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151569",
            "telephone_number": "877-712-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRYONE OF ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "WEIGAND",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-712-7875"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Cui
• David Jeremy Davidson, MD
• Amanda L. Deboy, LPC, PMH-C
• Deerfield Healthworks S C
• Caroline Degroot, MPT
• Paula T Dicanio, PHD.
• Susan A Dote, DPT
• Lisa Dvorak, LPC
• Joanne Eckenhoff, PT
• Robin P Eisenberg, LCSW

• General Practice Dentistry in Bannockburn, IL
• Providers in Bannockburn, 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 May 2, 2025; 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.