Active NPI
Gerard Michael Palsis Jr., D.M.D.
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1912292673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019028718
- Practice address
- 4410 S Pulaski Rd
Chicago, IL 60632-4011 - Phone
- (920) 838-1649
- NPI assigned
- Jun 10, 2011
- 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 | 019028718 | IL | Primary |
Addresses
Primary practice location
4410 S Pulaski Rd
Chicago, IL 60632-4011
Mailing address
430 W. Erie St.
Suite 200
Chicago, IL 60610
Phone (312) 274-0308
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 |
|---|---|---|---|
| 019028718 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gerard Palsis DMD PLLC | Current | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309824000000",
"number": "1912292673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 W. ERIE ST.",
"address_2": "SUITE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60610",
"telephone_number": "312-274-0308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 S PULASKI RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606324011",
"telephone_number": "920-838-1649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALSIS",
"first_name": "GERARD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-10",
"last_updated": "2011-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019028718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.