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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, P.C.

NPI Number 1184737363
LBN Legal business name DENTAL PROFESSIONALS OF ILLINOIS, P.C.
Authorized official RICHARD WORKMAN - (OWNER/PC PRESENDT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 08/15/2006
Last updated 08/10/2018 - About 8 years ago
Identifiers
IL License # 019-015765
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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