Jack Lawrence Lieberman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

01912631 Issued in IL

Practice address

5400 N Milwaukee Ave
Suite1Ms
Chicago, IL 60630-1272

Phone

(773) 774-4121

Fax

(773) 774-4123

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710940762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 N MILWAUKEE AVE",
            "address_2": "SUITE1MS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301272",
            "telephone_number": "773-774-4121",
            "fax_number": "773-774-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 N MILWAUKEE AVE",
            "address_2": "SUITE1MS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301272",
            "telephone_number": "773-774-4121",
            "fax_number": "773-774-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "JACK",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "01912631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002718",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Lieberman, PT, DPT
• Brittany Lieberman
• Caroline Lieberman
• Daniel A Lieberman, O.D.
• Emily Rose Lieberman, M.D.
• Lynne Lieberman
• Madison Ava Lieberman
• Lieberson Psychotherapy PLLC
• Kristin E Liebl, DPT
• Stephanie Liebl

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, 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 Jul 13, 2026; 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.