John Kenneth Favale

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

1604 Chicago Ave
Evanston, IL 60201-6017

Phone

(847) 866-8844

NPI assigned

Sep 29, 2006

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: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 18, 2014 through Nov 18, 2026

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Lindenhurst Dental Health Group

  • General Practice Dentistry
  • Lindenhurst, IL
  • NPI 1568550192
  NPD (past)
• Peter Chung Dental DMD LTD

  • Dental Clinic/Center
  • Lindenhurst, IL
  • NPI 1649008616
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821180696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 ADELPHIA AVE",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441502",
            "telephone_number": "847-295-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602016017",
            "telephone_number": "847-866-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVALE",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie J. Farrell, PA-C
• Claire K Farren, CRNA
• Dawn E. Farwell, APN-CNS
• Adelina Fassakhova, MD
• Bryn Aleah Favakeh
• Rachel Joy Fear, CNM
• Julia Terese Feczko, MS, CRNA
• Emily A. Feeny, PA-C
• Carrie Lynne Fehr, MT-BC
• Ryan Douglas Feichter, PHARMD

• General Practice Dentistry in Evanston, IL
• Providers in Evanston, 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 Jul 8, 2007; 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.