- Practice location
- 5622 W Touhy Ave, Niles, IL 60714-4001
- Phone
- 847-983-4202
- Fax
- 847-983-8403
- Last updated
- September 19, 2024
Pro Dental Il - Chad Wise PC is a healthcare organization based in Niles, IL. Pro Dental Il - Chad Wise PC practices in Niles, IL. The NPI Number for Pro Dental Il - Chad Wise PC is 1861229148. The current practice location address for Pro Dental Il - Chad Wise PC is 5622 W Touhy Ave, Niles, IL 60714-4001 and can be reached out via phone at 847-983-4202 and via fax at 847-983-8403.
Provider Profile Details
- NPI Number
- 1861229148
- Provider Name
- Pro Dental Il - Chad Wise PC
- Provider Entity Type
- Organization
- Address
- 5622 W Touhy Ave, Niles, IL 60714-4001
- Phone Number
- 847-983-4202
- Fax Number
- 847-983-8403
- Primary Taxonomy
- Dentist, General Practice · 1223G0001X
- Organization Subpart
- No
- Authorized Official
- Simone Wilson-Adeleke, MPA-PPA · Director Of Credentialing · 732-731-8398
- Other Names
- Destiny Dental Of Niles (Doing Business As)
- Provider Enumeration Date
- September 19, 2024
- Last Update Date
- September 19, 2024
- Certification Date
- September 19, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 5622 W Touhy Ave
Niles, IL 60714-4001 - City
- Niles
- State
- Illinois
- Zip
- 60714-4001
- Phone Number
- 847-983-4202
- Fax Number
- 847-983-8403
Provider Business Mailing Address Details
- Address
- 10 Woodbridge Center Dr Ste 520
Woodbridge, NJ 07095-1152 - City
- Woodbridge
- State
- NJ
- Zip
- 07095-1152
- Phone Number
- 732-731-8398
License Information
- Taxonomy
- Dentist, General Practice · 1223G0001X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Pro Dental Il - Chad Wise PC?
The NPI number of Pro Dental Il - Chad Wise PC is 1861229148. It was assigned on September 19, 2024 and is currently active in the NPPES registry.
What is the specialty of Pro Dental Il - Chad Wise PC?
Pro Dental Il - Chad Wise PC is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X).
Where does Pro Dental Il - Chad Wise PC practice?
The practice location is 5622 W Touhy Ave, Niles, IL 60714-4001. The office can be reached at 847-983-4202 (phone) or 847-983-8403 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1861229148 directly on the NPPES registry website.