Individual
DR. JERRY DVORACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
6169 N NORTHWEST HWY, CHICAGO, IL 60631-2140
(773) 792-2266
(773) 792-2272
Mailing address
2157 WESTVIEW DR, DES PLAINES, IL 60018-2646
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019021625
IL
Other
Enumeration date
06/15/2006
Last updated
11/09/2010
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