| Calumet Park Dental Inc. | |
|
1328 W 127th St Calumet Park IL 60827-6129 | |
| (708) 597-3131 | |
| (798) 597-1898 |
| Full Name | Calumet Park Dental Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1328 W 127th St, Calumet Park, Illinois |
| Authorized Official Name and Position | Shameema Essof (PRESIDENT) |
| Authorized Official Contact | 6308903123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Calumet Park Dental Inc. Po Box 179 Blue Island IL 60406-0179 Ph: (708) 597-3131 | Calumet Park Dental Inc. 1328 W 127th St Calumet Park IL 60827-6129 Ph: (708) 597-3131 |
| NPI Number | 1174994479 |
|---|---|
| Provider Enumeration Date | 10/13/2015 |
| Last Update Date | 10/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174994479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019023113 (Illinois) | Primary |
Shameema Essof Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1328 W 127th St, Calumet Park, IL 60827 Phone: 708-597-3131 Fax: 708-597-1230 |