Individual
DR. ANTHEA MARIE MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
25 E WASHINGTON ST STE 1707, CHICAGO, IL 60602-1806
(312) 429-7425
Mailing address
17W726 BUTTERFIELD RD APT 306, OAKBROOK TERRACE, IL 60181-4230
(574) 850-1557
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019031200
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
461088803
MILLENNIUM PARK SMILES LLC
IL
Enumeration date
06/22/2017
Last updated
06/22/2017
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