Edgebrook Periodontics & Implantology – Periodontics, NPI 1174633275

Edgebrook Periodontics & Implantology is a healthcare provider. based in Chicago, Illinois. specializing in Periodontics. The NPI Number for Edgebrook Periodontics & Implantology is 1174633275

Main info

Organization
Name
Edgebrook Periodontics & Implantology
NPI
1174633275
Phone
(773) 794-1299
Address
4801 W. PETERSON AVE
Authorized Official
DR. JUN SUP LIM PRESIDENT DDS, MS
Enumeration Date
30 August 2006
Last Update Date
22 August 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness80
Years active:19State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Edgebrook Periodontics & Implantology

  • Edens Office Plaza, 4801, West Peterson Avenue, Sauganash, Forest Glen, Chicago, Jefferson Township, Cook County, Illinois, 60646, United States

    STE #404

    CHICAGO, IL 60646

    Phone: (773) 794-1299

    Fax: (773) 794-1629

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60646)

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Reviews

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Frequently asked questions

What federal number belongs to Edgebrook Periodontics & Implantology?
The federal identifier for Edgebrook Periodontics & Implantology is NPI 1174633275.
Is Edgebrook Periodontics & Implantology active in the national directory?
Edgebrook Periodontics & Implantology's public NPI profile is in an active state.
What does Edgebrook Periodontics & Implantology treat or focus on?
Patients typically see Edgebrook Periodontics & Implantology under the specialty Periodontics. Clinical services aligned with this taxonomy classification.
What location shows for Edgebrook Periodontics & Implantology?
We surface Chicago, Illinois for Edgebrook Periodontics & Implantology based on available NPPES addresses.
Is Edgebrook Periodontics & Implantology a real provider?
This page reflects official NPPES data for NPI 1174633275. Always confirm identity and privileges with the practice and licensing boards.

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