Bryan C Bouchelion, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

021002012 Issued in IL

Practice address

10713 W 159TH St
Orland Park, IL 60467

Phone

(708) 301-5000

Fax

(708) 403-8966

NPI assigned

Nov 9, 2006

Last updated

May 22, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 10, 2020 through Jan 10, 2028

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.

• Louis N Korompilas DDS PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Orland Park, IL
  • NPI 1609947498
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1801966478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10713 W 159TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674531",
            "telephone_number": "708-301-5000",
            "fax_number": "708-403-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10713 W 159TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60467",
            "telephone_number": "708-301-5000",
            "fax_number": "708-403-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHELION",
        "first_name": "BRYAN",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021002012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Brigit Bosack, AUD
• Rebecca Bosack, D.D.S.
• Robert C. Bosack, DDS
• Cheryl Ann Boss, ANP-CNP
• Botti Sports & Spine
• Firdaus Boufath
• Bounce Back Chiropractic, Inc.
• Alexandra Maria Bournas, LPC
• John E. Bova, D.D.S., P.C.
• Kristine Michelle Bowen

• Oral and Maxillofacial Surgery (Dentist) in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; 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.