Dental Professionals of Illinois, P.c

NPI #1093399107 in Darien, Illinois

Provider Information

NPI Number: 1093399107
Entity Type: Organization
Organization Name: Dental Professionals of Illinois, P.c
Subpart: Yes (part of a larger organization)
Parent Organization: DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: May 6, 2021
Last Updated: May 6, 2021

Practice Location

Address: 2839 83RD ST
City: Darien
State: Illinois
ZIP Code: 60561-5612
Phone: (360) 871-5100

Authorized Official

Name: TABATHA LEMKE
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-6078

Specialties & Taxonomy Codes

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

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