| Hanover Park Dental Clinic, Llc | |
|
1098 E Lake St Hanover Park IL 60133-5431 | |
| (630) 483-7001 | |
| (630) 483-7041 |
| Full Name | Hanover Park Dental Clinic, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1098 E Lake St, Hanover Park, Illinois |
| Authorized Official Name and Position | Shirali M Patel (MEMBER) |
| Authorized Official Contact | 6304837001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hanover Park Dental Clinic, Llc 1098 E Lake St Hanover Park IL 60133-5431 Ph: (630) 483-7001 | Hanover Park Dental Clinic, Llc 1098 E Lake St Hanover Park IL 60133-5431 Ph: (630) 483-7001 |
| NPI Number | 1841464617 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 04/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841464617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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