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Stephanie Bollow
Pediatric Dentist in Chicago, Illinois
NPI 1639799901

Stephanie Bollow is a Pediatric Dentist based in Chicago, IL and is specialized in Pediatric Dentistry. Stephanie Bollow practices in Chicago, IL. The NPI Number for Stephanie Bollow is 1639799901 and holds a License No. (Illinois).

The current practice location address for Stephanie Bollow is 801 S Paulina St, Chicago, IL and can be reached out via phone at 312-996-7532.

Location: 801 S Paulina St, Chicago, IL, 60612-7210
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639799901
Provider Name
Stephanie Bollow
Credential
Provider Entity Type
Individual
Gender
Female
Address
801 S Paulina St, Chicago, IL, 60612-7210
Phone Number
312-996-7532
Fax Number
Provider Enumeration Date
04/16/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
801 S Paulina St
City
Chicago
State
Illinois
Zip
60612-7210
Phone Number
312-996-7532
Fax Number
person
Provider Business Mailing Address Details
Address
801 S Paulina St
City
Chicago
State
Illinois
Zip
60612-7210
Phone Number
312-996-7532
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
021.003194 (Illinois)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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