Organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Active
Parent organization
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Other names
Fox Lake Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official
JESSICA BRITT (CREDENTIALING COORDINATOR)
(217) 540-8426
Entity
Organization
Contact information
Practice address
1402 S US HIGHWAY 12, FOX LAKE, IL 60020-1252
(217) 540-5100
Mailing address
1402 S US HIGHWAY 12, FOX LAKE, IL 60020-1252
(847) 973-6765
(847) 973-6749
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/25/2018
Last updated
10/03/2018
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