Dr Clarissa Couch, DDS in Bridgeview, IL - Medicare Dentist Provider

Dr Clarissa Couch, DDS is a medicare enrolled "Dentist" provider in Bridgeview, Illinois. Her current practice location is 10220 S 76th Ave, Suite 250, Bridgeview, Illinois. You can reach out to her office (for appointments etc.) via phone at (708) 974-6160.

Dr Clarissa Couch is licensed to practice in Illinois (license number 019-022817) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447388764.

Contact Information

	Dr Clarissa Couch, DDS
	10220 S 76th Ave, Suite 250, Bridgeview, IL 60455-2425
	(708) 974-6160
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Clarissa Couch
Gender	Female
Speciality	Dentist
Location	10220 S 76th Ave, Bridgeview, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447388764
Provider Enumeration Date: 02/28/2007
Last Update Date: 04/22/2021

Medicare PECOS Information:

PECOS PAC ID: 2365759313
Enrollment ID: I20170509000922

Medical Identifiers

Medical identifiers for Dr Clarissa Couch such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447388764	NPI	-	NPPES
101942	Other	IL	TIN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223D0001X	Dentist - Dental Public Health	019022817 (Illinois)	Secondary
122300000X	Dentist	019-022817 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Clarissa Couch allows following entities to bill medicare on her behalf.

Entity Name	Cook County
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588612832 PECOS PAC ID: 2860398088 Enrollment ID: O20031209000747

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Clarissa Couch is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Clarissa Couch, DDS 2020w Harrison St, Chicago, IL 60612-3741 Ph: (312) 572-4788	Dr Clarissa Couch, DDS 10220 S 76th Ave, Suite 250, Bridgeview, IL 60455-2425 Ph: (708) 974-6160

Reviews and Comments

Dentist in Bridgeview, IL

Dr. Bana Adel Zayyad, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 8729 S Harlem Ave, Bridgeview, IL 60455 Phone: 708-599-6600
Dr. Najla Ahmad Al-rayyan, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 7374 W 87th St, Bridgeview, IL 60455 Phone: 708-599-4600 Fax: 708-599-6105
Joel A Akroush, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 8729 S Harlem Ave, Bridgeview, IL 60455 Phone: 708-974-3600 Fax: 708-974-3685
Waleed A Dajani, DDS Dentist Medicare: Medicare Enrolled Practice Location: 8550 S Harlem Ave, Suite C, Bridgeview, IL 60455 Phone: 708-598-5760
Dr. John F Torphy, DDS Dentist Medicare: Medicare Enrolled Practice Location: 7275 S Harlem Ave, Bridgeview, IL 60455 Phone: 708-594-2070
Dr. Terrence Robert Gilman Sr., D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 8233 S Harlem Ave, Bridgeview, IL 60455 Phone: 708-430-5088 Fax: 708-430-5090

Dr Clarissa Couch, DDS - Medicare Dentist in Bridgeview, IL