Dental Professionals of Illinois, PC

NPI #1902269079 in Lockport, Illinois

Provider Information

NPI Number: 1902269079
Entity Type: Organization
Organization Name: Dental Professionals of Illinois, PC
Subpart: Yes (part of a larger organization)
Parent Organization: DENTAL PROFESSIONALS OF ILLINOIS, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 5, 2016
Last Updated: Apr 5, 2016

Practice Location

Address: 16620 W 159TH ST
City: Lockport
State: Illinois
ZIP Code: 60441-8012
Phone: (815) 306-4275

Authorized Official

Name: KENDRA WALKER
Title: CREDENTIALING TEAM LEAD
Phone: (217) 540-8312

Specialties & Taxonomy Codes

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

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