Active NPI
Jardin Yousef, DMD
- Dentist
- Oakbrook Terrace, IL
National Provider Identifier
1629699715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019033881
- Practice address
- 1S660 Midwest Rd Ste 205
Oakbrook Terrace, IL 60181-4738 - Phone
- (630) 473-4550
- NPI assigned
- Apr 30, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019033881 | IL | Primary |
Addresses
Primary practice location
1S660 Midwest Rd Ste 205
Oakbrook Terrace, IL 60181-4738
Mailing address
1712 N Larch Dr
Mount Prospect, IL 60056-1647
Phone (224) 433-4733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200715000289 | WA | Order and Referring Only - Oral Surgery | 6204259856 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019033881 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1629699715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1712 N LARCH DR",
"city": "MOUNT PROSPECT",
"state": "IL",
"postal_code": "600561647",
"telephone_number": "224-433-4733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1S660 MIDWEST RD STE 205",
"city": "OAKBROOK TERRACE",
"state": "IL",
"postal_code": "601814738",
"telephone_number": "630-473-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUSEF",
"first_name": "JARDIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-30",
"last_updated": "2022-08-05",
"certification_date": "2022-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019033881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakbrook Terrace, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.