MEDICARE: JDM DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1710146964	OTHER		NPI

General Provider Information

NPI Number	:	1811623788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JDM DDS PC

Provider Business Mailing Address
First Line	:	1701 N SHEFFIELD AVE STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-5549
Country	:	US
Telephone Number	:	312-337-1665
Fax Number	:

Provider Business Practice Location Address
First Line	:	6315 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-3760
Country	:	US
Telephone Number	:	773-774-1493
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN D MANIKOWSKI
Credential	:	DDS
Telephone Number	:	312-213-4179

Provider Enumeration Date	:	07/25/2022
Last Update Date	:	07/25/2022

Similar Medicare Providers

1932109352 — DR. AMANDO A RENIVA M.D.
Practice Location Address:

6315 N MILWAUKEE AVE # A
CHICAGO, IL
60646-3760

Practice Phone: 847-679-1668
Practice Fax:

1639323942 — AMANDO A RENIVA MDSC
Practice Location Address:

6315 N MILWAUKEE AVE # A
CHICAGO, IL
60646-3760

Practice Phone: 847-698-0661
Practice Fax: 847-768-9132

1871514836 — RESURRECTION MEDICAL CENTER - CHICAGO LLC
Practice Location Address:

7447 W TALCOTT AVE
CHICAGO, IL
60631-3760

Practice Phone: 773-792-5030
Practice Fax: 773-594-7841

1720238058 — ALBERT F CHOI O.D.
Practice Location Address:

3760 N BROADWAY ST
CHICAGO, IL
60613-4105

Practice Phone: 773-975-2020
Practice Fax: 773-975-2085

1770884488 — INDUSTRIAL OPTICAL SERVICE, INC
Practice Location Address:

3760 N BROADWAY ST
CHICAGO, IL
60613-4105

Practice Phone: 773-975-2020
Practice Fax:

1427413327 — MYEYEDR OPTOMETRY OF ILLINOIS, LLC
Practice Location Address:

3760 N BROADWAY ST
CHICAGO, IL
60613-4105

Practice Phone: 773-975-2020
Practice Fax: 773-975-2085

Directions to “JDM DDS PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.