Suburban Periodontal Associates Limited
Dentist, Periodontics in Oak Brook, IL. Organization (NPI-2).
NPI number1578680765
StatusActive
Last updated in NPPESNov 10, 2015
Details
- NPI
- 1578680765
- Entity type
- Organization (NPI-2)
- Legal business name
- Suburban Periodontal Associates Limited
- Organization subpart
- No
- Enumeration date
- Mar 23, 2007
- Last updated
- Nov 10, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | 021601479 | IL | Yes |
Practice location
120 Oakbrook CenterSuite 600
Oak Brook, IL 60523
Phone 630-368-0605 · Fax 630-368-9616
Mailing address
120 Oakbrook CenterSuite 600
Oak Brook, IL 60523
Phone 630-368-0605 · Fax 630-368-9616
Authorized official
Gina D Gruendeman
President
6303680605
Is something wrong?
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Other Periodontics providers in Oak Brook, IL
- Dubravec Periodontal Associates, PCNPI 1114398831
- Gina D Gruendeman-Gordon, DDSNPI 1730356270
- Ryan Johnson, DMDNPI 1447924808
- Nolen L. Levine, D.D.S.NPI 1497933261
All 5 Periodontics providers in Oak Brook · All 1,344 providers in Oak Brook
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