Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Redwing Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(224) 788-7348
Entity
Organization
Contact information
Practice address
421 E IL ROUTE 173, ANTIOCH, IL 60002-9406
(847) 929-9736
Mailing address
421 E IL ROUTE 173, ANTIOCH, IL 60002-9406
(847) 929-9736
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/20/2019
Last updated
05/21/2019
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