Ellen E Tkach, D.d.s., P.c.

NPI #1700212040 in Evanston, Illinois

Provider Information

NPI Number: 1700212040
Entity Type: Organization
Organization Name: Ellen E Tkach, D.d.s., P.c.
Primary Specialty: Dentist
Enumeration Date: Sep 18, 2013
Last Updated: Sep 18, 2013

Practice Location

Address: 1029 HOWARD ST STE 201
City: Evanston
State: Illinois
ZIP Code: 60202-3877
Phone: (847) 431-4416

Authorized Official

Name: DR. ELLEN E TKACH, D.D.S.
Title: CEO/PRESIDENT
Phone: (847) 431-4416

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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