Individual provider Active NPI

Isabel Cristina Suastegui, DDS

  • General Practice Dentistry
  • Melrose Park, IL
National Provider Identifier
1639159221
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019022083 Issued in IL
Practice address
1835 Broadway St
210
Melrose Park, IL 60160-2040
Phone
(708) 345-1168
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019022083 IL Primary

Addresses

Primary practice location

1835 Broadway St
210
Melrose Park, IL 60160-2040

Mailing address

1835 Broadway St
Melrose Park, IL 60160-2040
Phone (708) 345-1168

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
I20160202001047 IL Order and Referring Only - DentistPractitioner - Dentist 6002110616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Isabel C. Suastegui-Mursuli DDS LTD Past Accepting new patients

Organizations & group practices 1

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639159221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 BROADWAY ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602040",
            "telephone_number": "708-345-1168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 BROADWAY ST",
            "address_2": "210",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601602040",
            "telephone_number": "708-345-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUASTEGUI",
        "first_name": "ISABEL",
        "middle_name": "CRISTINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.