Individual provider Active NPI

Bernard A Reusz, DDS

  • General Practice Dentistry
  • Downers Grove, IL
National Provider Identifier
1871625442
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
5010 Fairview Ave
Suite 4
Downers Grove, IL 60515-3999
Phone
(630) 769-1922
Fax
(630) 435-3973
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

5010 Fairview Ave
Suite 4
Downers Grove, IL 60515-3999

Mailing address

5010 Fairview Ave
Suite 4
Downers Grove, IL 60515-3999
Phone (630) 769-1922

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160429000428 IL Order and Referring Only - DentistPractitioner - Dentist 1052610870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019017891ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871625442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 FAIRVIEW AVE",
            "address_2": "SUITE 4",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153999",
            "telephone_number": "630-769-1922",
            "fax_number": "630-435-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 FAIRVIEW AVE",
            "address_2": "SUITE 4",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153999",
            "telephone_number": "630-769-1922",
            "fax_number": "630-435-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REUSZ",
        "first_name": "BERNARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "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": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.