Jerome Alan Correa, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019018843 Issued in IL

Practice address

62 Orland Square Dr
Suite 304
Orland Park, IL 60462-6546

Phone

(708) 349-1919

Fax

(708) 349-1990

NPI assigned

Jul 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 31, 2016 through Mar 31, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Orland Square Dental LLC

  • Dental Clinic/Center
  • Orland Park, IL
  • NPI 1134628597
  NPD (past)

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1750547782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 ORLAND SQUARE DR",
            "address_2": "SUITE 304",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626546",
            "telephone_number": "708-349-1919",
            "fax_number": "708-349-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 ORLAND SQUARE DR",
            "address_2": "SUITE 304",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626546",
            "telephone_number": "708-349-1919",
            "fax_number": "708-349-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "JEROME",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019018843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corepoint Medical LLC
• Sara Marie Coria-Macias, PSY.D.
• David A Cornell, D.O.
• Jonathan Cornet
• Madeline Corrao, RPH
• Julianne Cosentino, LCSW
• Khristian Binettalyn Cosey, MA
• Costco Wholesale Corporation
• Costco Wholesale Corporation (Costco Optical #647)
• Costco Wholesale Corporation (Costco Hearing Aid #647)

• General Practice Dentistry in Orland Park, IL
• Providers in Orland Park, 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 29, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.