Active NPI
Vadim Dekhtyar, L. AC.
- Acupuncturist
- Glenview, IL
National Provider Identifier
1750422580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- Practice address
- 3633 W Lake Ave Ste 303
Glenview, IL 60026-5803 - Phone
- (847) 724-1777
- Fax
- (847) 724-4488
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | IL | Primary |
Addresses
Primary practice location
3633 W Lake Ave Ste 303
Glenview, IL 60026-5803
Mailing address
6211 Lincoln Ave Unit 408
Morton Grove, IL 60053-2863
Phone (847) 965-0664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198000525 | IL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750422580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6211 LINCOLN AVE UNIT 408",
"city": "MORTON GROVE",
"state": "IL",
"postal_code": "600532863",
"telephone_number": "847-965-0664",
"fax_number": "847-724-4488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3633 W LAKE AVE STE 303",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600265803",
"telephone_number": "847-724-1777",
"fax_number": "847-724-4488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEKHTYAR",
"first_name": "VADIM",
"credential": "L. AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.