Ryan Peterson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.030355 Issued in IL

Practice address

360 Sherwood Rd
La Grange Park, IL 60526-1967

Phone

(708) 354-7363

NPI assigned

Aug 3, 2015

Last updated

Jun 24, 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

Enrolled in IL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lagrange Park Dentistry PC

  • Dental Clinic/Center
  • La Grange Park, IL
  • NPI 1114803822
  NPD Authorized official
• Edp of Illinois P.C

  dba Affordable Dental of Illnois

  • Dental Clinic/Center
  • Dupo, IL
  • NPI 1154712784
  NPD (past)
• James M Fieldhouse DDS LTD

  • Dentist
  • La Grange Park, IL
  • NPI 1255428637
  NPD (past)
• Walter D. Flor, D.D.S., LTD.

  dba Homewood-Flossmoor Dental Care

  • Dental Clinic/Center
  • Homewood, IL
  • NPI 1558668756
  NPD (past)

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1841676764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SHERWOOD RD",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261967",
            "telephone_number": "708-354-7363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SHERWOOD RD",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261967",
            "telephone_number": "708-354-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-03",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.030355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pelviccore Physical Therapy and Wellness
• Lisa Christine Perea, REGISTERED NURSE
• Erin Pereira, PT
• Lilybeth Perez
• Kathryn Peskor, OTR/L
• Pillars Community Health
• Pillars Community Health
• Pillars Community Health
• Pillars Community Health
• Pillars Community Health

• General Practice Dentistry in La Grange Park, IL
• Providers in La Grange Park, 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 Jun 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.