Active NPI
Beth Ann Jarosik, D.D.S.
- Dentist
- Flossmoor, IL
National Provider Identifier
1811076722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019-024291
- Practice address
- 2630 Flossmoor Rd
Suite 103
Flossmoor, IL 60422-1546 - Phone
- (708) 798-0990
- Fax
- (708) 798-3370
- NPI assigned
- Nov 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019-024291 | IL | Primary |
Addresses
Primary practice location
2630 Flossmoor Rd
Suite 103
Flossmoor, IL 60422-1546
Mailing address
6721 Pine Lake Dr
Tinley Park, IL 60477-4935
Phone (708) 429-4126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-024291 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811076722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6721 PINE LAKE DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604774935",
"telephone_number": "708-429-4126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 FLOSSMOOR RD",
"address_2": "SUITE 103",
"city": "FLOSSMOOR",
"state": "IL",
"postal_code": "604221546",
"telephone_number": "708-798-0990",
"fax_number": "708-798-3370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAROSIK",
"first_name": "BETH",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019-024291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flossmoor, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.