Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Periodontal Medicine and Surgical Specialists, LLC

Organization Periodontics · NPI 1386098390

Periodontal Medicine and Surgical Specialists, LLC provides 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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