Organization Active NPI

Elizabeth T Kalliath DMD PC

  • Dental Clinic/Center
  • Chicago, IL
National Provider Identifier
1972450138
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ELIZABETH T KALLIATH DMD PC
Practice address
111 N Wabash Ave Ste 1820
Chicago, IL 60602-2973
Phone
(312) 236-3633
NPI assigned
Mar 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Authorized official

Name
Elizabeth Kalliath, DMDNPI 1467868455
Title
Dentist
Phone
(256) 810-1987

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

111 N Wabash Ave Ste 1820
Chicago, IL 60602-2973

Mailing address

3037 N Seminary Ave
Chicago, IL 60657-4335
Phone (256) 810-1987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260330000906 IL DME Supplier - Oral Surgery - Dentist 2860977782 Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1972450138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3037 N SEMINARY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574335",
            "telephone_number": "256-810-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE STE 1820",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606022973",
            "telephone_number": "312-236-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH T KALLIATH DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "KALLIATH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "256-810-1987",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "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 Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.