Individual
DR. ANTHONY J. PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5912 W LAWRENCE AVE, CHICAGO, IL 60630-3130
(773) 282-1541
(773) 282-4881
Mailing address
5912 W LAWRENCE AVE, CHICAGO, IL 60630-3130
(773) 282-1541
(773) 282-4881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19A15148
IL
1223P0300X
Periodontics
021001289
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021001200
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0080016184
BCBS MEDICAL PROVIDER #
IL
Enumeration date
03/14/2007
Last updated
05/29/2013
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