NPIMap

Organization Active NPI

Russell J. Cecala, D.D.S., M.S., LTD Dba Periocare

  • Periodontics
  • Chicago, IL
National Provider Identifier
1841318805
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
RUSSELL J. CECALA, D.D.S., M.S., LTD DBA PERIOCARE
Doing business as
PerioCare
Practice address
7447 W Talcott Ave
Suite 227
Chicago, IL 60631-3745
Phone
(773) 631-0344
Fax
(773) 631-0211
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Russell J. Cecala, D.D.S.,M.S.NPI 1487772422
Title
President/Owner
Phone
(773) 631-0344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X IL Primary

Addresses

Primary practice location

7447 W Talcott Ave
Suite 227
Chicago, IL 60631-3745

Mailing address

7447 W Talcott Ave
Suite 227
Chicago, IL 60631-3745
Phone (773) 631-0344

Other names 1

  • PerioCare Doing business as

National Provider Directory

National Provider Directory

Locations

7447 W Talcott Ave
Ste 227
Chicago, IL 60631
Phone (773) 631-0344

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1841318805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 227",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-631-0344",
            "fax_number": "773-631-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 W TALCOTT AVE",
            "address_2": "SUITE 227",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313745",
            "telephone_number": "773-631-0344",
            "fax_number": "773-631-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL J. CECALA, D.D.S., M.S., LTD DBA PERIOCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "CECALA",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "773-631-0344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S.,M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PerioCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.