Organization
DENTAL PROFESSIONALS OF ILLINOIS, PC
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, PC
Other names
Dental Care of Round Lake Beach
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, PC
Authorized official
KENDRA WALKER (CREDENTIALING COORDINATOR)
(217) 540-8312
Entity
Organization
Contact information
Practice address
418 E ROLLINS RD, ROUND LAKE BEACH, IL 60073-1334
(847) 752-0990
Mailing address
418 E ROLLINS RD, ROUND LAKE BEACH, IL 60073-1334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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