ILLINOIS DENTAL PROFESSIONALS PC NPI 1689326175

NPI Information

  • NPI: 1689326175
  • Provider Name: ILLINOIS DENTAL PROFESSIONALS PC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 405 S MAIN ST
    NAPERVILLE, IL
    ZIP 60540
  • Phone: (630) 357-7273

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NPI Details

ILLINOIS DENTAL PROFESSIONALS PC is an oral and maxillofacial surgery dentist in Naperville, IL. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. ILLINOIS DENTAL PROFESSIONALS PC NPI is 1689326175. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

405 S MAIN ST
NAPERVILLE, IL
ZIP 60540-322
Phone: (630) 357-7273

The provider's authorized official is Hillary Thull .
The authorized official title is Credentialing Coordinator and has the following contact phone number (217) 540-8946.

The enumeration date for this NPI number is 1/25/2022 and was last updated on 1/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 3/30/2025

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