| Ellen E Tkach, D.d.s., P.c. | |
|
1029 Howard St Ste 201 Evanston IL 60202-3877 | |
| (847) 431-4416 | |
| Not Available |
| Full Name | Ellen E Tkach, D.d.s., P.c. |
|---|---|
| Speciality | Dentist |
| Location | 1029 Howard St Ste 201, Evanston, Illinois |
| Authorized Official Name and Position | Ellen E Tkach (CEO/PRESIDENT) |
| Authorized Official Contact | 8474314416 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen E Tkach, D.d.s., P.c. 1029 Howard St Ste 201 Evanston IL 60202-3877 Ph: (847) 431-4416 | Ellen E Tkach, D.d.s., P.c. 1029 Howard St Ste 201 Evanston IL 60202-3877 Ph: (847) 431-4416 |
| NPI Number | 1700212040 |
|---|---|
| Provider Enumeration Date | 09/18/2013 |
| Last Update Date | 09/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700212040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019021157 (Illinois) | Primary |
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