Individual
RONALD LISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 GRAND CANYON PARKWAY, SUITE 106, HOFFMAN ESTATES, IL 60169-1705
(847) 519-0600
(847) 519-0693
Mailing address
1000 GRAND CANYON PARKWAY, SUITE 106, HOFFMAN ESTATES, IL 60169-1705
(847) 519-0600
(847) 519-0693
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19022882
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31552
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/18/2006
Last updated
05/14/2025
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