| Elk Grove Dental, Llc | |
|
1121 Nerge Rd Elk Grove Village IL 60007-3260 | |
| (847) 895-0000 | |
| Not Available |
| Full Name | Elk Grove Dental, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1121 Nerge Rd, Elk Grove Village, Illinois |
| Authorized Official Name and Position | A. Khan (STAFF) |
| Authorized Official Contact | 8478950000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elk Grove Dental, Llc 1121 Nerge Rd Elk Grove Village IL 60007-3260 Ph: (847) 895-0000 | Elk Grove Dental, Llc 1121 Nerge Rd Elk Grove Village IL 60007-3260 Ph: (847) 895-0000 |
| NPI Number | 1336505171 |
|---|---|
| Provider Enumeration Date | 01/09/2016 |
| Last Update Date | 02/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336505171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019.024689 (Illinois) | Secondary |
| 122300000X | Dentist | 019.025459 (Illinois) | Primary |
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