Jhared Black, DMD | |
135 Henson Ct, Matteson, IL 60443-3012 | |
(708) 743-9685 | |
Not Available |
Full Name | Jhared Black |
---|---|
Gender | Male |
Speciality | Dentist |
Location | 135 Henson Ct, Matteson, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578017505 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 12013820A (Indiana) | Secondary |
122300000X | Dentist | 019030918 (Illinois) | Primary |
Entity Name | Community Healthnet Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952332298 PECOS PAC ID: 6305852344 Enrollment ID: O20060228000318 |
Mailing Address | Practice Location Address |
---|---|
Jhared Black, DMD 3677 Sauk Trl, Richton Park, IL 60471-1461 Ph: (708) 481-2288 | Jhared Black, DMD 135 Henson Ct, Matteson, IL 60443-3012 Ph: (708) 743-9685 |
Dr. Robert J Manasse, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 4440 Lincoln Hwy, Suite 300, Matteson, IL 60443 Phone: 708-481-6086 Fax: 708-481-2525 | |
Dr. William C Selmer, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 3716 W 217th St., Matteson, IL 60443 Phone: 305-992-3339 | |
Dr. Harold K Shinsky, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 4557a. Lincoln Mall Drive, Matteson, IL 60443 Phone: 708-747-7447 |