Active NPI
Manal Yasin, D.D.S.
- Dentist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019030479
- Practice address
- 5425 W Lake St
Chicago, IL 60644-2342 - Phone
- (773) 378-3347
- Fax
- (773) 378-4028
- NPI assigned
- Aug 15, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS039944 | PA | |
| Dentist | 122300000X | 019030479 | IL | Primary |
Addresses
Primary practice location
5425 W Lake St
Chicago, IL 60644-2342
Mailing address
107 Saint Tropez Cir
Beaver Falls, PA 15010-3174
Other practice location 1
7372 McKnight Rd Ste B
Pittsburgh, PA 15237-3558
Phone (412) 837-3026
Other practice location 2
6201 Roosevelt Rd
Berwyn, IL 60402-1108
Phone (708) 386-0845
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019030479 | IL | MD | Dentist |
| DS039944 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Erie Family Health Center Inc | Current | Accepting new patients | |
| PCC Community Wellness Center | Current | Accepting new patients | |
| Erie Family Health Center, Inc | Current | Accepting new patients | |
| Erie Family Health Center Inc | Current | Accepting new patients | |
| PCC Community Wellness Center | Current | Accepting new patients |
Locations
6201 Roosevelt Rd
Berwyn, IL 60402
Phone (708) 386-0845
5425 W Lake St
Chicago, IL 60644
Phone (773) 378-3347
1504 S Albany Ave
Chicago, IL 60623
1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381
1285 Hartrey Ave
Evanston, IL 60202
Phone (847) 666-2302
14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113
Interoperability endpoints
- manal.yasin.1@13158.direct.athenahealth.com
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1760499545
-
- Federally Qualified Health Center (FQHC)
- Oak Park, IL
- NPI 1871516799
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1548062318
-
- Federally Qualified Health Center (FQHC)
- Evanston, IL
- NPI 1629328836
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1134954506
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577404800000",
"number": "1811320799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 SAINT TROPEZ CIR",
"city": "BEAVER FALLS",
"state": "PA",
"postal_code": "150103174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5425 W LAKE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606442342",
"telephone_number": "773-378-3347",
"fax_number": "773-378-4028"
}
],
"practiceLocations": [
{
"address_1": "7372 McKnight Rd Ste B",
"address_purpose": "LOCATION",
"city": "Pittsburgh",
"state": "PA",
"postal_code": "152373558",
"country_code": "US",
"telephone_number": "412-837-3026",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6201 Roosevelt Rd",
"address_purpose": "LOCATION",
"city": "Berwyn",
"state": "IL",
"postal_code": "604021108",
"country_code": "US",
"telephone_number": "708-386-0845",
"fax_number": "708-386-8472",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YASIN",
"first_name": "MANAL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-15",
"last_updated": "2019-12-27",
"certification_date": "2019-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039944",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019030479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.