John William Polivka, DDS is a
Dentist based in La Grange Highlands, Illinois. John William Polivka is licensed to practice in Illinois (license number 019.029578) and his current practice location is
11000 Jann Ct, La Grange Highlands, Illinois. He can be reached at his office (for appointments etc.) via phone at
(708) 699-6659.
NPI number for John William Polivka is 1891126454 and his current mailing address is 11000 Jann Ct, La Grange Highlands, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1891126454.
Healthcare Provider's Profile
Full Name | John William Polivka |
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Gender | Male |
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Speciality | Dentist |
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Location | 11000 Jann Ct, La Grange Highlands, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1891126454
- Provider Enumeration Date: 12/09/2013
- Last Update Date: 12/09/2013
Medical Identifiers
Medical identifiers for John William Polivka such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1891126454 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 019.029578 (Illinois) | Primary |
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. John William Polivka is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
John William Polivka, DDS 11000 Jann Ct, La Grange Highlands, IL 60525-7308 Ph: (708) 699-6659 | John William Polivka, DDS 11000 Jann Ct, La Grange Highlands, IL 60525-7308 Ph: (708) 699-6659 |
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