Active NPI
Joseph Malecki Jr.
- General Practice Dentistry
- Aurora, IL
National Provider Identifier
1881112639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.031383
- Practice address
- 1940 W Galena Blvd Ste 3
Aurora, IL 60506-4482 - Phone
- (630) 892-7041
- NPI assigned
- Aug 31, 2017
- Reactivated
- Jul 18, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.031383 | IL | Primary |
Addresses
Primary practice location
1940 W Galena Blvd Ste 3
Aurora, IL 60506-4482
Mailing address
1940 W Galena Blvd Ste 3
Aurora, IL 60506-4482
Phone (630) 892-7041
Other practice location 1
12420 Archer Ave
Lemont, IL 60439-6733
Phone (630) 243-9851
Other practice location 2
6233 W 55th St
Chicago, IL 60638-2530
Phone (773) 284-2259
Other practice location 3
538 W North Ave
Elmhurst, IL 60126-2105
Phone (630) 833-0122
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.031383 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547164800000",
"number": "1881112639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1940 W GALENA BLVD STE 3",
"city": "AURORA",
"state": "IL",
"postal_code": "605064482",
"telephone_number": "630-892-7041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1940 W GALENA BLVD STE 3",
"city": "AURORA",
"state": "IL",
"postal_code": "605064482",
"telephone_number": "630-892-7041"
}
],
"practiceLocations": [
{
"address_1": "12420 Archer Ave",
"address_purpose": "LOCATION",
"city": "Lemont",
"state": "IL",
"postal_code": "604396733",
"country_code": "US",
"telephone_number": "630-243-9851",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6233 W 55th St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606382530",
"country_code": "US",
"telephone_number": "773-284-2259",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "538 W North Ave",
"address_purpose": "LOCATION",
"city": "Elmhurst",
"state": "IL",
"postal_code": "601262105",
"country_code": "US",
"telephone_number": "630-833-0122",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALECKI",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-31",
"last_updated": "2019-01-11",
"deactivation_date": "2018-04-12",
"reactivation_date": "2018-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.031383",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.