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Contact Information

DENTAL PROFESSIONALS OF ILLINOIS, P.C.
1411 W LANE RD STE B
MACHESNEY PARK, IL61115
 Phone: 815-981-9075
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DENTAL PROFESSIONALS OF ILLINOIS, P.C.

NPI Number 1053713966
LBN Legal business name DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official LINDSAY BEARDEN - (CREDENTIALING COORDINATOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/23/2014
Last updated 09/23/2014 - About 12 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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