Abidemi Gbotosho, DDS | |
1650 S Albany Ave, Chicago, IL 60623-2251 | |
(347) 416-3147 | |
Not Available |
Full Name | Abidemi Gbotosho |
---|---|
Gender | Female |
Speciality | Dentist |
Location | 1650 S Albany Ave, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205145976 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 0026015 (Texas) | Secondary |
122300000X | Dentist | 019029289 (Illinois) | Primary |
Entity Name | Northwestern Medical Faculty Foundation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346235314 PECOS PAC ID: 4587576814 Enrollment ID: O20031105000541 |
Entity Name | Cook County |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588612832 PECOS PAC ID: 2860398088 Enrollment ID: O20031209000747 |
Mailing Address | Practice Location Address |
---|---|
Abidemi Gbotosho, DDS 1650 S Albany Ave, Chicago, IL 60623-2251 Ph: (347) 416-3147 | Abidemi Gbotosho, DDS 1650 S Albany Ave, Chicago, IL 60623-2251 Ph: (347) 416-3147 |
Dr. Philip E Fidel, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 3236 W Fullerton Ave, Chicago, IL 60647 Phone: 773-276-0300 Fax: 773-252-5994 | |
Bilus D Poles, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1945 W Wilson Ave, Chicago, IL 60640 Phone: 773-275-8855 | |
Theresa Westfallen, Dentist Medicare: Not Enrolled in Medicare Practice Location: 1738 W North Ave, Chicago, IL 60622 Phone: 773-276-5566 Fax: 773-276-8780 | |
Dr. Justine S Gasior, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 6820 S Pulaski Rd, Chicago, IL 60629 Phone: 773-581-4627 Fax: 773-581-3155 | |
Dr. William Kwok Kuen Wan, M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 2262 S. Wentworth Ave, 2nd Floor, Chicago, IL 60616 Phone: 312-791-1013 Fax: 312-791-1444 | |
Gandy S Garcia, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 3915 W 26th St, Chicago, IL 60623 Phone: 773-522-2929 Fax: 773-522-2930 | |
Dr. Sodabeh Etminan, DMD Dentist Medicare: Medicare Enrolled Practice Location: 7131 S Jeffery Blvd Ste A, Chicago, IL 60649 Phone: 773-256-0526 |