PETTY & DRAGSTREM ORTHODONTICS, LLC (NPI# 1285144154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285144154 |
| Entity Type | Organization |
| Organization Name | PETTY & DRAGSTREM ORTHODONTICS, LLC |
| Practice Address |
5455 Wolf Rd Western Springs IL 60558-1853 |
| Practice Telephone | 7082464000 |
| Mailing Telephone | 7082464000 |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | KRISTINA DRAGSTREM (OWNER) |
| Authorized Official Telephone | 7082464000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
248001868 | IL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4230 Westbrook Dr Unit B, Aurora, IL 605044125 | 6308516888 |
| Street Address |
5455 WOLF RD |
| City | WESTERN SPRINGS |
| State | IL |
| Zip Code | 60558-1853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821220344 | Anthony T Young | Dentist | 5455 Wolf Rd, Western Springs, IL 60558-1853 | 2009-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194280941 | Kenneth J. Szafranski, Dds, Ltd Matthew S. Van Beek, Dds | Dentist | 1100 Hillgrove Ave, Suite 1&2, Western Springs, IL 60558 | 2019-02-06 |
| 1942782313 | Tom Schimel | Counselor | 1023 Burlington Avenue, Western Springs, IL 60558 | 2018-09-03 |
| 1760904692 | Megan Sullivan | Social Worker | 1405 Willow Ave., Western Springs, IL 60558 | 2017-07-12 |
| 1205281763 | Cara Bowton | Student in an Organized Health Care Education/Training Program | 4051 Linden Ave, Western Springs, IL 60558 | 2016-05-03 |
| 1598109803 | Megan Marie Tierney | Student in an Organized Health Care Education/Training Program | 5001 Lawn Ave, Western Springs, IL 60558 | 2013-04-18 |
| 1013275189 | Farouk Fahim Girgis | Specialist | 5731 Grand Avenue, Western Springs, IL 60558 | 2012-04-26 |
| 1346516507 | Dara Kruchko | Occupational Therapist | 3839 Central Ave., Western Springs, IL 60558 | 2012-03-31 |
| 1346540697 | John Vrchota IIi | Pharmacist | #14 Garden Market St, Western Springs, IL 60558 | 2010-11-02 |
| 1447574637 | Ryan Schmaedeke | Physical Therapist | 4700 Gilbert Ave Ste 43a, Western Springs, IL 60558 | 2010-03-17 |
| 1043463664 | Matthew David Peahl | Chiropractor | 1052 Hillgrove Ave., Western Springs, IL 60558 | 2008-10-28 |
| Find all providers in zip 60558 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376051656 | Spring Orthodontics | Dentist | 800 Hillgrove Ave Ste 200, Western Springs, IL 60558-1566 | 2018-01-20 |
| 1821220344 | Anthony T Young | Dentist | 5455 Wolf Rd, Western Springs, IL 60558-1853 | 2009-08-17 |
| 1093998254 | Owen Harold Hilding | Dentist | 4365 Lawn Ave, Western Springs, IL 60558-1465 | 2007-12-11 |
| 1679602312 | Mark Edward Runge | Dentist | 518 Hillgrove Avenue, Suite 100, Western Springs, IL 60558-1480 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427670421 | Braces By Barnes | Dentist | 1335 E 87th St Ste B, Chicago, IL 60619-7036 | 2020-05-12 |
| 1790310431 | Gregory D Long II | Dentist | 7131 N Knoxville Ave Ste B, Peoria, IL 61614-2088 | 2020-03-03 |
| 1073147682 | Collinsville Orthodontics Pllc | Dentist | 93 Crestmoor St, Collinsville, IL 62234-4952 | 2020-02-24 |
| 1740812494 | Bankhead Alton Orthodontics PC | Dentist | 2828 Homer Adams Pkwy, Alton, IL 62002-4855 | 2020-02-11 |
| 1336779164 | Orthodontic Experts, Ltd | Dentist | 2987 Kirk Rd Ste 103a, Aurora, IL 60502-6014 | 2020-01-21 |
| 1922645308 | Riddhi J Desai Dmd Pllc | Dentist | 727 W Madison St Apt 1208, Chicago, IL 60661-2409 | 2019-12-04 |
| 1295379691 | Orthodontic Experts, Ltd | Dentist | 1351 N Larkin Ave, Joliet, IL 60435-3753 | 2019-10-30 |
| 1407409071 | Barysenka LLC | Dentist | 124 N California St, Sycamore, IL 60178-1402 | 2019-07-22 |
| 1346806577 | Pulaski Smiling Dental P.C. | Dentist | 5540 S Pulaski Rd Fl 1, Chicago, IL 60629-4418 | 2019-05-13 |
| 1750944252 | Candid Illinois, Pllc | Dentist | 750 N Franklin St Fl Stc2, Chicago, IL 60654-6263 | 2019-04-19 |
| Find all providers with the same taxonomy | ||||
| City | WESTERN SPRINGS |
| Zip Code | 60558 |
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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.