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Contact Information

PRAIRIE ORTHODONTICS PC
6121 WASHINGTON ST
SUITE 204
GURNEE, IL60031
 Phone: 847-249-8800
 Fax: 847-249-8869
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthodontics and Dentofacial Orthopedics

1223X0400X
Indicates primary specialty

NPI Profile & details for PRAIRIE ORTHODONTICS PC

NPI Number 1033284831
LBN Legal business name PRAIRIE ORTHODONTICS PC
Authorized official BRIDGET MUELLER - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/21/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
IL License # 06006486
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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