OrganizationActive
Periodontics & Implants, Ltd.
NPI 1962653600 · Periodontics · Evanston, IL
Provider details
- NPI number
- 1962653600
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Richard Prendergast, President/Periodontist(847) 491-1880
- License
- 021000596 (IL)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
636 Church St
Suite 707
Evanston, IL 60201-4508
Phone: (847) 491-1880
Street-level locationGet directions
Mailing address
636 Church St
Evanston, IL 60201-4508
Registry dates
- Enumerated
- 2008-09-30
- Last updated
- 2008-09-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.