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Contact Information

ARTISAN DENTAL GROUP OF ILLINOIS LLC
649 N 1ST BANK DR
PALATINE, IL60067-8111
 Phone: 847-934-4200
 Fax: 847-934-4294
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Periodontics

1223P0300X
Indicates primary specialty

NPI Profile & details for ARTISAN DENTAL GROUP OF ILLINOIS LLC

NPI Number 1619412087
LBN Legal business name ARTISAN DENTAL GROUP OF ILLINOIS LLC
Authorized official DONNA MADDALOZZO - (PRESIDENT/CO-OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/21/2016
Last updated 12/21/2016 - About 9 years ago
Identifiers
IL License # 019019847
IL License # 019019961
IL License # 019021223
IL License # 021001354
IL License # 021001430
IL License # 021001510
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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