Individual provider Active NPI

Saul David Legator, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1912013152
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
4801 W Peterson Ave
Suite 400
Chicago, IL 60646
Phone
(773) 545-5121
Fax
(773) 304-0264
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

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
Dentist 122300000X IL Primary

Addresses

Primary practice location

4801 W Peterson Ave
Suite 400
Chicago, IL 60646

Mailing address

4801 W Peterson Ave
Suite 400
Chicago, IL 60646
Phone (773) 545-5121

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
I20160607001601 IL Practitioner - Oral Surgery 1658675459 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912013152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "SUITE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60646",
            "telephone_number": "773-545-5121",
            "fax_number": "773-304-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "SUITE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60646",
            "telephone_number": "773-545-5121",
            "fax_number": "773-304-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGATOR",
        "first_name": "SAUL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.