| James L Derrico Dds | |
|
6448 College Rd Lisle IL 60532-3290 | |
| (630) 983-8700 | |
| (630) 983-8512 |
| Full Name | James L Derrico Dds |
|---|---|
| Speciality | Dentist |
| Location | 6448 College Rd, Lisle, Illinois |
| Authorized Official Name and Position | James L. Derrico (OWNER) |
| Authorized Official Contact | 6309838700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James L Derrico Dds 6448 College Rd Lisle IL 60532-3290 Ph: (630) 983-8700 | James L Derrico Dds 6448 College Rd Lisle IL 60532-3290 Ph: (630) 983-8700 |
| NPI Number | 1144604224 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 07/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144604224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019.019814 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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