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

Periodontics Ltd

Organization Periodontics · NPI 1336219856

Periodontics Ltd is a Periodontics in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 N Wabash Ave Ste 919
Chicago, IL 60602-1932
Phone: (312) 641-2572
Fax: (312) 641-6621
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X (IL)

Record details

NPI number1336219856
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Russo — Periodontist · (312) 641-2572
NPI enumeratedNovember 9, 2006
Last updated in NPPESAugust 22, 2020
Mailing address111 N Wabash Ave Ste 919, Chicago, IL 60602-1932

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