DR. RENJU ALEX THACKENKARY (NPI# 1932410297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932410297 |
| Entity Type | Individual |
| Full Name | DR. RENJU ALEX THACKENKARY |
| Credential | BDS,DDS |
| Practice Address |
120 E Court St Toulon IL 61483-5388 |
| Practice Telephone | 3092867240 |
| Mailing Telephone | 3092867240 |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2013-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019028383 | IL | Dental Providers |
| Street Address |
120 E COURT ST |
| City | TOULON |
| State | IL |
| Zip Code | 61483-5388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700836509 | Melisa Mundwiler | Nurse Practitioner | 120 E Court St, Toulon, IL 61483-5388 | 2006-05-11 |
| 1891034906 | North Central Behavioral Health Systems, Inc. | Clinic/Center | 120 E Court St, Toulon, IL 61483-5388 | 2013-02-08 |
| 1699948224 | Aunt Marthas Youth Service Center Inc | Clinic/Center | 120 E Court St, Toulon, IL 61483-5388 | 2008-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134131949 | Stark County Ambulance Service Inc | Ambulance | 114 N Franklin St, Toulon, IL 61483 | 2006-08-12 |
| 1013950179 | Amy Marie Snyder | Chiropractor | 104 S. East St., Toulon, IL 61483 | 2006-06-14 |
| 1720045164 | Petersen Management Company LLC | Skilled Nursing Facility | Highway 17 East, Toulon, IL 61483 | 2006-04-28 |
| 1255533766 | Stark County Community Unit School District 100 | Local Education Agency (LEA) | 402 S Franklin, Toulon, IL 61483-0659 | 2007-06-05 |
| 1528219607 | Advanced Physical Therapy Services, Ltd. | Physical Therapist | 322 Downend Rd, Toulon, IL 61483-5089 | 2008-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528219607 | Advanced Physical Therapy Services, Ltd. | Physical Therapist | 322 Downend Rd, Toulon, IL 61483-5089 | 2008-10-07 |
| 1255533766 | Stark County Community Unit School District 100 | Local Education Agency (LEA) | 402 S Franklin, Toulon, IL 61483-0659 | 2007-06-05 |
| 1134131949 | Stark County Ambulance Service Inc | Ambulance | 114 N Franklin St, Toulon, IL 61483 | 2006-08-12 |
| 1013950179 | Amy Marie Snyder | Chiropractor | 104 S. East St., Toulon, IL 61483 | 2006-06-14 |
| 1720045164 | Petersen Management Company LLC | Skilled Nursing Facility | Highway 17 East, Toulon, IL 61483 | 2006-04-28 |
| 1982855136 | Petersen Health Care II, Inc | Skilled Nursing Facility | Highway 17 East, Toulon, IL 61438 | 2008-10-07 |
| 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 |
|---|---|---|---|---|
| 1104425230 | Sundeep Franklin Dmd & Daiana Capota Dmd Pllc | Dentist | 320 N Mclean Blvd Ste B, Elgin, IL 60123-3220 | 2020-10-20 |
| 1801403555 | Stephanie Elizabeth Miller | Dentist | 2220 Sisters Ave, Naperville, IL 60564-4394 | 2020-09-27 |
| 1417564121 | Gursimran Reen, Dmd LLC | Dentist | 29 S Webster St Ste 108, Naperville, IL 60540-5353 | 2020-09-26 |
| 1285240531 | Summit Dental Center LLC | Dentist | 7710 W 62nd Pl, Summit, IL 60501-1702 | 2020-09-22 |
| 1295340628 | Karina Valentin | Dentist | 1534 N Oakley Blvd Apt 3f, Chicago, IL 60622-1783 | 2020-09-11 |
| 1932713583 | Kevin G Reardon | Dentist | 479 S Spring Rd, Elmhurst, IL 60126-3857 | 2020-09-01 |
| 1831702307 | Sms Dental LLC | Dentist | 17727 Halsted St, Homewood, IL 60430 | 2020-08-25 |
| 1548870884 | Daniel Patrick Jurgens | Dentist | 2 N Country Club Rd Ste 2, Decatur, IL 62521-4174 | 2020-08-02 |
| 1184233934 | Shawna Jade Dudovitz | Dentist | 309 Tamarack Ln, Shiloh, IL 62269-2993 | 2020-07-28 |
| 1417565748 | Robert Hails | Dentist | 3540 N Belt W Ste B, Belleville, IL 62226-5975 | 2020-07-22 |
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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.