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Organization
YELENA M REVICH DDS LTD
Active
Organization
YELENA M REVICH DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YELENA M REVICH DDS (PRESIDENT)
(847) 494-5819
Entity
Organization
Contact information
Practice address
1455 E GOLF RD, # 209, DES PLAINES, IL 60016-1250
(847) 296-3733
Mailing address
1455 E GOLF RD, # 209, DES PLAINES, IL 60016-1250
(847) 296-3733
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9177154
—
IL
Enumeration date
03/24/2008
Last updated
03/24/2008
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