Individual
JOSE VILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1426 W BELMONT AVE, CHICAGO, IL 60657-2111
(773) 528-0068
(773) 528-0088
Mailing address
1426 W BELMONT AVE, CHICAGO, IL 60657-2111
(773) 528-0068
(773) 528-0088
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2019021973
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363914276
DENTAL
IL
Enumeration date
11/28/2006
Last updated
07/08/2007
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