Active NPI
Yevgen Tkachuk
- General Practice Dentistry
- Glenview, IL
National Provider Identifier
1902234594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019029513
- Practice address
- 2604 Patriot Blvd
Suite B
Glenview, IL 60026-8024 - Phone
- (312) 544-9384
- NPI assigned
- Oct 17, 2013
- Last updated
- Oct 17, 2013
- 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 | 019029513 | IL | Primary |
Addresses
Primary practice location
2604 Patriot Blvd
Suite B
Glenview, IL 60026-8024
Mailing address
4238 N Bloomington Ave
Apt #203
Arlington Heights, IL 60004-8310
Phone (312) 544-9384
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 |
|---|---|---|---|
| 019029513 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yevgen Tkachuk DDS PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Buffalo Grove, IL
- NPI 1154872174
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381968000000",
"number": "1902234594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4238 N BLOOMINGTON AVE",
"address_2": "APT #203",
"city": "ARLINGTON HEIGHTS",
"state": "IL",
"postal_code": "600048310",
"telephone_number": "312-544-9384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2604 PATRIOT BLVD",
"address_2": "SUITE B",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268024",
"telephone_number": "312-544-9384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TKACHUK",
"first_name": "YEVGEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-17",
"last_updated": "2013-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019029513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenview, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.