NPIMap

Organization Active NPI

Paul Imhof/Raymond Jeleniauskas DDS

  • Dentist
  • Des Plaines, IL
National Provider Identifier
1629202791
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-015281 Issued in IL
Legal business name
PAUL IMHOF/RAYMOND JELENIAUSKAS DDS
Practice address
1645 S River Rd
Des Plaines, IL 60018-2206
Phone
(847) 299-4811
Fax
(847) 299-4379
NPI assigned
May 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2009

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

Authorized official

Name
Dr. Paul C Imhof, DDSNPI 1417140534
Title
President
Phone
(847) 299-4811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019-015281 IL Primary

Addresses

Primary practice location

1645 S River Rd
Des Plaines, IL 60018-2206

Mailing address

1645 S River Rd
Des Plaines, IL 60018-2206
Phone (847) 299-4811

National Provider Directory

National Provider Directory

Locations

1645 S River Rd
Des Plaines, IL 60018
Phone (224) 803-2273

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1629202791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 S RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600182206",
            "telephone_number": "847-299-4811",
            "fax_number": "847-299-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 S RIVER RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600182206",
            "telephone_number": "847-299-4811",
            "fax_number": "847-299-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL IMHOF/RAYMOND JELENIAUSKAS DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "IMHOF",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-299-4811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-015281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.