Organization
IRVING PARK FAMILY DENTIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVANA BUENO (DIRECTOR OF CORPORATE OPERATIONS)
(773) 798-9382
Entity
Organization
Contact information
Practice address
3435 W IRVING PARK RD, CHICAGO, IL 60618-3217
(773) 588-8200
(773) 588-8208
Mailing address
3435 W IRVING PARK RD, CHICAGO, IL 60618-3217
(773) 588-8200
(773) 588-8208
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019024678
IL
Other
Enumeration date
06/13/2011
Last updated
10/13/2025
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