Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Periodontal Medicine and Surgical Specialists, LLC

Organization Periodontics · NPI 1386098390

Periodontal Medicine and Surgical Specialists, LLC is a Periodontics in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1009 W Webster Ave
Chicago, IL 60614-3502
Phone: (630) 627-3930
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 021001938 (IL)
Periodontics Taxonomy 1223P0300X · Licence 021002676 (IL)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 021002351 (IL)
Dental Clinic/Center Taxonomy 261QD0000X

Record details

NPI number1386098390
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official George Mandelaris — President · (630) 627-3930
Other names Periodontal Medicine And Surgical Specialists, Ltd
NPI enumeratedApril 15, 2016
Last updated in NPPESDecember 23, 2016
Mailing address1s224 Summit Ave, Suite 205, Oakbrook Terrace, IL 60181-3983

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