DR. IRENE T. THEODORE (NPI# 1871756767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871756767 |
| Entity Type | Individual |
| Full Name | DR. IRENE T. THEODORE |
| Credential | DDS |
| Practice Address |
4200 W Peterson Ave Suite 136 Chicago IL 60646-6074 |
| Practice Telephone | 7732865286 |
| Practice Fax Number | 7732865331 |
| Mailing Telephone | 7732865286 |
| Mailing Fax Number | 7732865331 |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019020903 | IL | Dental Providers |
| Street Address |
4200 W PETERSON AVE SUITE 136 |
| 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 |
| 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 |
| 1811026669 | Krell-reuben Oral Surgery Ltd. | Dentist | 4200 W Peterson Ave, Suite 128, Chicago, IL 60646-6074 | 2007-03-05 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1679181895 | Robert J Chacon | Dentist | 15 S Throop St Apt 206, Chicago, IL 60607-2522 | 2020-07-14 |
| 1629693304 | Priyanka Sikka | Dentist | 300 W Grand Ave Apt 303, Chicago, IL 60654-7855 | 2020-06-09 |
| 1164045456 | Yong Chang Dds PC. | Dentist | 3531 N Western Ave Unit B, Chicago, IL 60618-6025 | 2020-05-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1831749944 | Kenwood Dental Group | Dentist | 1335 E 87th St Ste A, Chicago, IL 60619-7036 | 2019-09-19 |
| 1508412875 | Kamal Paresh Patel | Dentist | 1040 W Randolph St, Chicago, IL 60607-2215 | 2019-08-13 |
| 1003469636 | Ahmed Mansour | Dentist | 2122 N Milwaukee Ave Ste 1, Chicago, IL 60647-4251 | 2019-07-23 |
| 1568024925 | John Michael Burnheimer II | Dentist | 11 S Green St Unit 1106, Chicago, IL 60607-1031 | 2019-07-05 |
| 1497317515 | Prasanth Dommaraju | Dentist | 3924 S Archer Ave, Chicago, IL 60632-1116 | 2019-06-29 |
| 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.