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Contact Information

DENTAL PROFESSIONALS OF ILLINOIS, P.C.
1111 EAST WALNUT STREET
CARBONDALE, IL62901
 Phone: 618-529-2471
 Fax: 618-529-2482
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DENTAL PROFESSIONALS OF ILLINOIS PC · (Female)

NPI # 1184737363
Status Active
Credentials
Entity Individual
Enumeration date 08/15/2006
Last updated 08/10/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 019-015765
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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