Individual provider Active NPI

Chris Nikolovski, DDS

  • Dentist
  • Burbank, IL
National Provider Identifier
1780744094
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019024482 Issued in IL
Practice address
6320 W 79TH St
Burbank, IL 60459
Phone
(708) 599-3333
Fax
(708) 599-1017
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019024482 IL Primary

Addresses

Primary practice location

6320 W 79TH St
Burbank, IL 60459

Mailing address

211 W Chicago Ave
Ste 117
Hinsdale, IL 60521-3357
Phone (630) 986-5150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160429000175 IL Order and Referring Only - DentistPractitioner - Dentist 6406155217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019024482ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chris Nikolovski DDS PC Past Accepting new patients
Michael Kowalik DDS LTD Past Accepting new patients
Hinsdale Dental Associates, PC Past Accepting new patients
Chris Nikolovski DDS PC Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1780744094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W CHICAGO AVE",
            "address_2": "STE 117",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213357",
            "telephone_number": "630-986-5150",
            "fax_number": "630-986-5984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W 79TH ST",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "60459",
            "telephone_number": "708-599-3333",
            "fax_number": "708-599-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLOVSKI",
        "first_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019024482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

Verify at the official NPI Registry.