Steven Daniel Hennessy, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019019744 Issued in IL

Practice address

3722 S. Harlem Ave
Suite 203
Riverside, IL 60546-2334

Phone

(708) 442-5657

Fax

(708) 442-0362

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

Yes

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1770527475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1071 DEVONSHIRE AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406271",
            "telephone_number": "630-561-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3722 S. HARLEM AVE",
            "address_2": "SUITE 203",
            "city": "RIVERSIDE",
            "state": "IL",
            "postal_code": "605462334",
            "telephone_number": "708-442-5657",
            "fax_number": "708-442-0362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "STEVEN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9819",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Margaret Hejna, LCPC
• Michael J Hejna, M.D., PHD.
• Jenae Angelle Henao, LPC- INTERN
• Erling Ho, MD
• Mara Hutton, PT
• Brian Paul Igoe, M.D.
• Michelle A Imes, M.S., CCC-SLP
• Itsa Journey, LLC

• All providers in Riverside, IL
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.