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Organization
SONRISA CCHC CAPITATION LLC
Active
Organization
SONRISA CCHC CAPITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON K KORKUS DDS (OWNER/PRESIDENT)
(312) 722-6460
Entity
Organization
Contact information
Practice address
9718 S HALSTED ST, CHICAGO, IL 60628-1007
(872) 703-3032
(312) 893-2275
Mailing address
3520 S MORGAN ST STE 207-208, CHICAGO, IL 60609-1533
(312) 722-6460
(312) 893-2275
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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