| Ellen E. Tkach, Dds, P.c. | |
|
1464 Townline Rd Mundelein IL 60060-4433 | |
| (847) 566-7850 | |
| (847) 566-7851 |
| Full Name | Ellen E. Tkach, Dds, P.c. |
|---|---|
| Speciality | Dentist |
| Location | 1464 Townline Rd, Mundelein, Illinois |
| Authorized Official Name and Position | Ellen E Tkach (DENTIST) |
| Authorized Official Contact | 8474314416 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen E. Tkach, Dds, P.c. 1464 Townline Rd Mundelein IL 60060-4433 Ph: (847) 566-7850 | Ellen E. Tkach, Dds, P.c. 1464 Townline Rd Mundelein IL 60060-4433 Ph: (847) 566-7850 |
| NPI Number | 1336540863 |
|---|---|
| Provider Enumeration Date | 09/16/2014 |
| Last Update Date | 09/16/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336540863 | NPI | - | NPPES |
| 1194998252 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019-021157 (Illinois) | Primary |
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