DR. ELLIOTT T. DEWEESE (NPI# 1013304724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013304724 |
| Entity Type | Individual |
| Full Name | DR. ELLIOTT T. DEWEESE |
| Credential | D.M.D., M.S.D. |
| Practice Address |
7447 W Talcott Ave. Suite 227 Chicago IL 60631 |
| Practice Telephone | 7736310344 |
| Practice Fax Number | 7736310211 |
| Mailing Telephone | 7736310344 |
| Mailing Fax Number | 7736310211 |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2018-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
021-002881 | IL | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
7447 W TALCOTT AVE. SUITE 227 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427686609 | Martha Agnes Bissing | Student in an Organized Health Care Education/Training Program | Resurrection Medical Education, Karen Dwulat, 7435 W. Talcott Avenue, Chicago, IL 60631 | 2020-04-01 |
| 1497383434 | Kathryn Lee Hughes | Student in an Organized Health Care Education/Training Program | 7435 W Talcott Avenue, Medical Education, Karen Dwulat, Chicago, IL 60631 | 2020-03-27 |
| 1245723121 | Thomas Walsh | Student in an Organized Health Care Education/Training Program | Resurrection Family Medicine 7447 W Talcott Ave, Ste 182, Chicago, IL 60631 | 2018-06-14 |
| 1912411893 | Briggs Therapy Group, LLC | Social Worker | 6645 N Oliphant Ave Ste F, Chicago, IL 60631 | 2017-11-29 |
| 1013467257 | Elsa Methipara | Nurse Practitioner | 6429 N Ogallah, Chicago, IL 60631 | 2016-10-12 |
| 1477001766 | Djje Holdings LLC | Psychologist | 8609 W Bryn Mawr Ave Ste 204, Chicago, IL 60631 | 2016-09-14 |
| 1538512884 | Sprout Pediatric Dentistry | Dentist | 6036 North Northwest Highway, Chicago, IL 60631 | 2016-07-21 |
| 1417305137 | Christopher Louis Scodeller | Emergency Medicine | 7435 W. Talcott A, Presence Resurrection Medical Center, Chicago, IL 60631 | 2016-06-03 |
| 1518315464 | Corbin Barwegen | Emergency Medicine | 7435 W. Talcott Ave., Chicago, IL 60631 | 2016-06-01 |
| 1639582562 | Andrew Skolarz | Family Medicine | 7447 W Talcott Ave Ste 366, Chicago, IL 60631 | 2014-06-09 |
| Find all providers in zip 60631 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145183 | Dental Dream Team Associates LLC Yetta Mccullom Sole Mbr | Dentist | 820 E 87th St Ste 201, Chicago, IL 60619-6256 | 2019-10-09 |
| 1508355678 | Periodontal Associates, LLP | Dentist | 845 N Michigan Ave Ste 940w, Chicago, IL 60611-2216 | 2018-05-04 |
| 1417377417 | Kate Quinlin | Dentist | 939 W North Ave Ste 700, Chicago, IL 60642-7839 | 2014-04-17 |
| 1437597598 | Carmen Villasante Graves | Dentist | Rm.458 Mc 859, 801 S. Paulina St, Chicago, IL 60612 | 2013-06-11 |
| 1972781961 | Daniel M Weber | Dentist | 25 E Washington, #1125, Chicago, IL 60602 | 2008-02-01 |
| 1699809202 | Stephen P Russo | Dentist | 25 E. Washington St, Suite 1125, Chicago, IL 60602 | 2007-03-15 |
| 1366572802 | Christine M Gadia | Dentist | 223 W. Jackson Blvd, #1275, Chicago, IL 60606-6908 | 2007-03-06 |
| 1700915105 | Loyola M. Gleason | Dentist | 5945 S Pulaski Rd, Chicago, IL 60629-4550 | 2007-03-04 |
| 1790833192 | Thomas F. Schneider Jr. | Dentist | 4949 W Irving Park Rd Ste D, Chicago, IL 60641-2641 | 2007-01-08 |
| 1336219856 | Periodontics Ltd. | Dentist | 111 N Wabash Ave Ste 919, Chicago, IL 60602-1932 | 2006-11-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.