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Contact Information

BRENDA J TAYLOR, DMD
701 WEST 111TH STREET
CHICAGO, IL60628
 Phone: 773-995-1234
 Fax: 773-995-9796
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for BRENDA J TAYLOR · (Female)

NPI # 1114017662
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 10/13/2006
Last updated 04/30/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 019-023707
  • IL License # 019023707
  • IN Medicaid 200248120
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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