Pro Dental Il - Chad Wise PC

NPI #1023845302 in Chicago, Illinois

Provider Information

NPI Number: 1023845302
Entity Type: Organization
Organization Name: Pro Dental Il - Chad Wise PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 19, 2024
Last Updated: Sep 19, 2024

Practice Location

Address: 712 E 87TH ST STE D
City: Chicago
State: Illinois
ZIP Code: 60619-6246
Phone: (773) 783-9000

Authorized Official

Name: SIMONE WILSON-ADELEKE, MPA-PPA
Title: DIRECTOR OF CREDENTIALING
Phone: (732) 731-8398

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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