Organization
OLD ORCHARD ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL YOUNG DMD (OWNER/ENDODONTIST)
(219) 741-3936
Entity
Organization
Contact information
Practice address
4905 OLD ORCHARD CTR STE 216, SKOKIE, IL 60077-4741
(219) 741-3937
Mailing address
1214 N WOOD ST UNIT 101, CHICAGO, IL 60622-3250
(219) 741-3937
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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