JOHN MICALETTI (NPI# 1912124660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912124660 |
| Entity Type | Individual |
| Full Name | JOHN MICALETTI |
| Credential | D.D.S., M.S. |
| Practice Address |
115 55th St Suite 201 Clarendon Hills IL 60514-1593 |
| Practice Telephone | 6307890900 |
| Practice Fax Number | 6307893861 |
| Mailing Telephone | 6307890900 |
| Mailing Fax Number | 6307893861 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
IL | Dental Providers |
| Street Address |
115 55TH ST SUITE 201 |
| City | CLARENDON HILLS |
| State | IL |
| Zip Code | 60514-1593 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659466522 | Ronald W. Goers | Dentist | 115 55th St, Suite 201, Clarendon Hills, IL 60514-1593 | 2006-10-04 |
| 1609387521 | Lissa E Trice | Psychologist | 115 55th St, Clarendon Hills, IL 60514-1593 | 2017-10-18 |
| 1730309980 | Keri Johnson | Dental Hygienist | 115 55th St, Suite 201, Clarendon Hills, IL 60514-1593 | 2007-04-30 |
| 1558580142 | Veronica Robledo | Dental Hygienist | 115 55th St, Suite 201, Clarendon Hills, IL 60514-1593 | 2007-04-24 |
| 1750500443 | Bethany Micaletti | Dental Hygienist | 115 55th St, Suite 201, Clarendon Hills, IL 60514-1593 | 2007-04-24 |
| 1205053949 | Mary Beth Hastings | Dental Hygienist | 115 55th St, Suite 201, Clarendon Hills, IL 60514-1593 | 2007-04-20 |
| 1215154026 | Kimberly Kazumura | Dentist | 115 55th St, Suite 201, Clarendon Hills, IL 60514-1593 | 2007-04-20 |
| 1851467179 | Cmk Home Health Agency Inc | Home Health | 115 55th St, Suite 202, Clarendon Hills, IL 60514-1593 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104844 | Michele Blidy | Occupational Therapist | 215 55th Street, Clarendon Hills, IL 60514 | 2018-11-27 |
| 1073093845 | Leah Tarabour | Speech-Language Pathologist | 49 Waverly Ave, Clarendon Hills, IL 60514 | 2018-08-20 |
| 1376022467 | Barbara Case Boules | Dietitian, Registered | 229 Park Avenue, Apt. 202, Clarendon Hills, IL 60514 | 2018-08-09 |
| 1942790647 | Weston Shelton | Chiropractor | 140 Burlington Ave, Clarendon Hills, IL 60514 | 2018-05-17 |
| 1700052834 | Donald V Maduzia O.d. P.C. | Optometrist | 203 Railroad Avenue, Clarendon Hills, IL 60514 | 2008-05-08 |
| 1134325673 | Pamela A Sirtak | Counselor | 284 Woodstock, 2c, Claredon Hills, IL 60514 | 2007-06-22 |
| 1538389531 | John Peter Wortel | Dentist | 235 Burlington Avenue, Clarendon Hills, IL 60514 | 2007-05-01 |
| 1164649778 | Jenny Scaffede | Pharmacist | 3020 S Wolf Road, Westchester, IL 60514 | 2007-04-18 |
| 1245388842 | Charles Philippou | Optometrist | 403 E Ogden, Clarendon Hills, IL 60514 | 2007-01-08 |
| 1518049626 | Donald Maduzia | Optometrist | 203 Railroad Drive, Donald Maduzia Od, Clarendon Hills, IL 60514 | 2006-10-19 |
| Find all providers in zip 60514 | ||||
| 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 |
|---|---|---|---|---|
| 1891309399 | Dominik Dubravec Dds Mmsc PC | Dentist | 555 W Court St Ste 202, Kankakee, IL 60901-3674 | 2020-09-02 |
| 1598374167 | Dubravec Periodontal Specialists PC | Dentist | 20635 Abbey Woods Ct N Ste 203, Frankfort, IL 60423-3186 | 2020-07-29 |
| 1972145183 | Dental Dream Team Associates LLC Yetta Mccullom Sole Mbr | Dentist | 820 E 87th St Ste 201, Chicago, IL 60619-6256 | 2019-10-09 |
| 1083192389 | Amirreza Ghassemi | Dentist | 2800 College Ave Bldg 285, Alton, IL 62002-4742 | 2018-07-30 |
| 1508355678 | Periodontal Associates, LLP | Dentist | 845 N Michigan Ave Ste 940w, Chicago, IL 60611-2216 | 2018-05-04 |
| 1043750714 | Bloomingdale Dental Rez, PC | Dentist | 1 Tiffany Pt Ste 209, Bloomingdale, IL 60108-2916 | 2017-03-01 |
| 1114398831 | Dubravec Periodontal Associates, PC | Dentist | 1900 Spring Rd, Suite 205, Oak Brook, IL 60523-1447 | 2015-10-08 |
| 1689059297 | Amer Atassi | Dentist | 6224 S Elm St, Burr Ridge, IL 60527-5228 | 2015-07-24 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
| 1215345939 | Mark Kolozenski, Dds, Ms, PC | Dentist | 10083 W Lincoln Hwy, Frankfort, IL 60423-1272 | 2014-07-25 |
| Find all providers with the same taxonomy | ||||
| City | CLARENDON HILLS |
| Zip Code | 60514 |
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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.