Individual
DR. MARYLENE VITIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1525 E 55TH ST STE 303, CHICAGO, IL 60615
(773) 947-9994
(773) 947-8281
Mailing address
1525 E 55TH ST STE 303, CHICAGO, IL 60615-5512
(773) 947-9994
(773) 947-8281
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
021001441
IL
1223P0221X
Pediatric Dentistry
Primary
021001441
IL
Other
Enumeration date
01/15/2015
Last updated
05/24/2018
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