Individual provider Active NPI

Angelika Kluska, DDS

  • General Practice Dentistry
  • Orland Park, IL
National Provider Identifier
1992535413
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.035446 Issued in IL
Practice address
9763 W 143Rd St Ste a
Orland Park, IL 60462-2575
Phone
(708) 349-3443
NPI assigned
Aug 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.035446 IL Primary

Addresses

Primary practice location

9763 W 143Rd St Ste a
Orland Park, IL 60462-2575

Mailing address

12421 Portrush LN
Lemont, IL 60439-9368
Phone (708) 262-2779

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

LicenseStateTypeSpecialty
019.035446ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1992535413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12421 PORTRUSH LN",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604399368",
            "telephone_number": "708-262-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9763 W 143RD ST STE A",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622575",
            "telephone_number": "708-349-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUSKA",
        "first_name": "ANGELIKA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-07",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.