Dental Professionals of Illinois, P.c

NPI #1457817983 in Antioch, Illinois

Provider Information

NPI Number: 1457817983
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: Feb 20, 2019
Last Updated: May 21, 2019

Practice Location

Address: 421 E IL ROUTE 173
City: Antioch
State: Illinois
ZIP Code: 60002-9406
Phone: (847) 929-9736

Authorized Official

Name: JESSICA BRITT
Title: CREDENTIALING COORDINATOR
Phone: (224) 788-7348

Specialties & Taxonomy Codes

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

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