Jacob Edward Postula, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.033843 Issued in IL

Practice address

2001 4TH St
Peru, IL 61354-3208

Phone

(815) 223-0171

NPI assigned

Apr 5, 2022

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1750022430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 N 2929TH RD",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613019632",
            "telephone_number": "815-252-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 4TH ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613543208",
            "telephone_number": "815-223-0171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332186",
            "country_code": "US",
            "telephone_number": "414-288-6790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POSTULA",
        "first_name": "JACOB",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.033843",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plattner Orthopedic Company (Hanger Clinic Plattner)
• Plattner Pedorthic Services
• Julie Pleskovitch, RPH
• Torie Ploch, COTA
• Andrea V Politsch, M.A. CCC-SLP
• Lawrence J Powell, D.O.
• Robert Powell, M.S.
• Bridget A Pratt, FNP
• Debra Lynn Pyszka
• Quad City Prosthetic Inc

• General Practice Dentistry in Peru, IL
• Providers in Peru, 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 Jun 28, 2022; 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.