DR. RICHARD D ISAACSON DDS NPI 1639267511

NPI Information

NPI: 1639267511
Provider Name: DR. RICHARD D ISAACSON, DDS
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
444 N NORTHWEST HWY
STE 325
PARK RIDGE, IL
ZIP 60068
Phone: (847) 296-6100
Get Directions

DR. Richard D Isaacson, DDS is an oral and maxillofacial surgery dentist in Park Ridge, IL. The provider is an oral and maxillofacial surgery dentist specialized in 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. DR. Richard D Isaacson, DDS NPI is 1639267511. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

444 N NORTHWEST HWY
STE 325
PARK RIDGE, IL
ZIP 60068
Phone: (847) 296-6100
Fax: (847) 296-8706

The NPI 1639267511 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 10/10/2006 and was last updated on 7/11/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	137000092	ILLINOIS	No
2	122300000X	Dentist		19016864	ILLINOIS	No
3	1223S0112X	Dentist	Oral and Maxillofacial Surgery	021001197	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	K17843	MEDICARE ID-TYPE UNSPECIFIED
2	0080004915	OTHER	ILLINOIS	BLUE CROSS GROUP
3	T38022	MEDICARE UPIN
4	K17842	MEDICARE ID-TYPE UNSPECIFIED		MEMBER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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