Individual provider Active NPI

Alexander Katsnelson, DMD, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Buffalo Grove, IL
National Provider Identifier
1982885208
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
021.002389 Issued in IL
Practice address
488 Thorndale Dr
Buffalo Grove, IL 60089-6700
Phone
(847) 902-9922
NPI assigned
Nov 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.027513 IL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 021.002389 IL Primary

Addresses

Primary practice location

488 Thorndale Dr
Buffalo Grove, IL 60089-6700

Mailing address

488 Thorndale Dr
Buffalo Grove, IL 60089-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 25, 2026 through Apr 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019.027513ILMDDentist
021.002389ILMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • Direct secure messaging: akatsnelson281472@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1982885208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 THORNDALE DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 THORNDALE DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896700",
            "telephone_number": "847-902-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATSNELSON",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.027513",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021.002389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.