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Active NPI 1508494469 Individual Practitioner Female Practitioner

Dr. Shelby Quinn Coulter Koschuck , DDS

Dentist - General Practice • Maywood, IL

Professional Overview & Biography Verified Profile Summary

Dr. Shelby Koschuck, DDS is a registered healthcare professional specializing in Dentist - General Practice in Maywood, IL. Practice services are available at 2160 S 1ST AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2160 S 1st Ave

Maywood, IL 601533328

Telephone 7083273041
Fax 7083273489
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Maywood, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
19 Specialists

Practicing in Maywood, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-09-13
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 018002146

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

27 Associated Practitioners
NPI 1013209444

Doctor of Dental Surgery, Master of Science

NPI 1013657816

Doctor of Medicine (M.D.)

NPI 1104168442
Dr. Cameron Walker , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1104260314

Doctor of Dental Surgery

NPI 1114260692

Doctor of Dental Surgery

Dr. Lohith Bose , MD

Plastic Surgery

NPI 1134382120

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2020

Dentist (License #018002146 in IL)

NPI Profile Active March 27, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location March 27, 2020

Registered at 2160 S 1ST AVE, MAYWOOD, IL 601533328 (Tel: 7083273041)

📍
Updated Business Mailing Address March 27, 2020

Registered at 846 KENWOOD BLVD., WINDSOR, ONT N9J3C5

👤
Provider Name / Credentials Updated March 27, 2020

Recorded as SHELBY KOSCHUCK, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 27, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 27, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508494469
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 27, 2020
Last Update: September 13, 2020
Sole Proprietor: No

Mailing Address

846 Kenwood Blvd.

Windsor, ONT N9J3C5

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.