KRELL-REUBEN ORAL SURGERY LTD. (NPI# 1811026669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811026669 |
| Entity Type | Organization |
| Organization Name | KRELL-REUBEN ORAL SURGERY LTD. |
| Practice Address |
4200 W Peterson Ave Suite 128 Chicago IL 60646-6074 |
| Practice Telephone | 7737776332 |
| Mailing Telephone | 7737776332 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BRUCE MICHAEL REUBEN (ORAL SURGEON) |
| Authorized Official Telephone | 7737776332 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
4200 W PETERSON AVE SUITE 128 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60646-6074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669470217 | Michael A. Krell | Dentist | 4200 W Peterson Ave, Suite 128, Chicago, IL 60646-6074 | 2005-07-08 |
| 1336502434 | Mark Jiaras Ltd | Community/Behavioral Health | 4200 W Peterson Ave, Suite 105, Chicago, IL 60646-6074 | 2016-04-05 |
| 1366748329 | Danielle N Keller | Audiologist | 4200 W Peterson Ave, Suite 100, Chicago, IL 60646-6074 | 2011-02-08 |
| 1508006313 | Jacobson Orthodontic Associates, Ltd | Dentist | 4200 W Peterson Ave, Suite 116, Chicago, IL 60646-6074 | 2009-03-06 |
| 1871756767 | Irene T. Theodore | Dentist | 4200 W Peterson Ave, Suite 136, Chicago, IL 60646-6074 | 2008-07-09 |
| 1558528646 | Rachelle Hasson Miller | Psychiatry & Neurology | 4200 W Peterson Ave, Suite 105, Chicago, IL 60646-6074 | 2008-05-18 |
| 1396912499 | Tundi M Frank | Dentist | 4200 W Peterson Ave, Suite 114, Chicago, IL 60646-6074 | 2008-05-08 |
| 1881812550 | Bailey Norman Jacobson | Dentist | 4200 W Peterson Ave, Suite 116, Chicago, IL 60646-6074 | 2007-04-20 |
| 1821120122 | Ronald Jacobson | Dentist | 4200 W Peterson Ave, Suite 116, Chicago, IL 60646-6074 | 2007-03-12 |
| 1417095530 | Sauganash Center for Dental Health Ltd | Dentist | 4200 W Peterson Ave, Suite 114, Chicago, IL 60646-6052 | 2007-02-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801312087 | Manal Ibrahim | Dentist | 6228 N Keystone Ave, Chicago, IL 60646 | 2017-08-18 |
| 1750820742 | Kaitlin O'brien | Student in an Organized Health Care Education/Training Program | 5801 N Pulaski, Chicago, IL 60646 | 2017-02-23 |
| 1659810646 | Sofia Trani | Student in an Organized Health Care Education/Training Program | 5801 N. Pulaski Rd, Chicago, IL 60646 | 2017-02-23 |
| 1487191151 | Ronald E. Rysztogi | Naprapath | 5704 N. Austin, Chicago, IL 60646 | 2017-01-19 |
| 1417403148 | Joyful Dental Care | Clinic/Center | 6314 N. Cicero Avenue, Chicago, IL 60646 | 2016-09-01 |
| 1164889754 | Physicians At Call | Family Medicine | 5901 N. Cicero Ave, Ste 207, Chicago, IL 60646 | 2016-01-27 |
| 1245610617 | Arlett Payne | Physician Assistant | 5906 N Milwaukee, Chicago, IL 60646 | 2015-06-01 |
| 1811375843 | North River Mental Health Center | Community/Behavioral Health | 5801 North Pulaski Road, Chicago, IL 60646 | 2015-05-11 |
| 1003157298 | Family Choice Home Health | Homemaker | 5933 N Milwaukee Avenue, Chicago, IL 60646 | 2013-03-13 |
| 1235479593 | Antonina Skapars Trinkuns | Psychiatry & Neurology | 6404 N. Tahoma Ave., Chicago, IL 60646 | 2013-02-25 |
| Find all providers in zip 60646 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1962769422 | Dr. Sunil Sinha and Associates Inc. | Dentist | 850 South Wabash Avenue, Suite 310, Chicago, IL 60605 | 2012-04-20 |
| 1669746418 | Biraj M. Shah | Dentist | 1900 W Polk St Ste 612, Chicago, IL 60612 | 2012-02-25 |
| 1417248261 | Jordan Ray Ledger | Dentist | 1229 W Washington Blvd, Suite 220, Chicago, IL 60607-2132 | 2011-04-27 |
| 1336377456 | Jason Sean Schrotenboer | Dentist | 3927 W Belmont Ave Ste 101, Chicago, IL 60618-5170 | 2009-06-26 |
| 1326293226 | Richard J Bret | Dentist | 7100 W. Higgins, Chicago, IL 60656 | 2008-11-20 |
| 1467607556 | Ora Studios | Dentist | 1827 S Michigan Ave, Chicago, IL 60616-1601 | 2008-11-18 |
| 1831342377 | Raza Ali Hussain | Dentist | 1025 W Monroe St Unit 3w, Chicago, IL 60607-2745 | 2008-10-28 |
| 1760679294 | Armitage Oral Surgery | Dentist | 2220 W Armitage Ave, Chicago, IL 60647-4461 | 2007-09-28 |
| 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.