| |
290 Center Dr Vernon Hills IL 60061-1518 | |
(847) 367-1640 | |
Not Available |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 290 Center Dr, Vernon Hills, Illinois |
Authorized Official Name and Position | Casey Lonabocker (VP OPERATIONS & STRATEGY) |
Authorized Official Contact | 6175353364 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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290 Center Dr Vernon Hills IL 60061-1518 Ph: (847) 367-1640 | 290 Center Dr Vernon Hills IL 60061-1518 Ph: (847) 367-1640 |
NPI Number | 1538849096 |
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Provider Enumeration Date | 07/20/2023 |
Last Update Date | 11/20/2024 |
Identifier | Type | State | Issuer |
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1538849096 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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