Jamie Ann Korolyov, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.030290 Issued in IL

Practice address

5912 W Lawrence Ave
Chicago, IL 60630-3305

Phone

(773) 282-1541

NPI assigned

Jul 28, 2015

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

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

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

Medicare enrollment (NPD)

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.

• Park Place Dental LLC

  • Dentist
  • Elmwood Park, IL
  • NPI 1316100514
  NPD (past)
• Parker and Associates, D.D.S, P.C.

  • Dentist
  • Chicago, IL
  • NPI 1366889503
  NPD (past)

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1801271184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 W NORTH AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074123",
            "telephone_number": "708-453-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5912 W LAWRENCE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303305",
            "telephone_number": "773-282-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROLYOV",
        "first_name": "JAMIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.030290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Claire Kornfeld
• Michael Kornfeld, MD
• Sarena Arlene Korni, LCPC
• Lisa M Kornita, DPT
• Victoria Alexandra Korol, DMD
• Mikhail Korolyov, D.M.D.
• Banio P Koroma, MD
• Michael James Koronkowski, PHARM.D.
• Michalina Christina Koronkowski
• Jenifer Corinne Korotko, LCPC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, 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 Aug 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.