| Kintsugi Group PLLC | |
|
1879 N Milwaukee Ave Ste 1 Chicago IL 60647-5689 | |
| (312) 429-6506 | |
| Not Available |
| Full Name | Kintsugi Group PLLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1879 N Milwaukee Ave Ste 1, Chicago, Illinois |
| Authorized Official Name and Position | Luis Peralta (OWNER) |
| Authorized Official Contact | 9177424608 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kintsugi Group PLLC 1879 N Milwaukee Ave Ste 1 Chicago IL 60647-5689 Ph: (312) 429-6506 | Kintsugi Group PLLC 1879 N Milwaukee Ave Ste 1 Chicago IL 60647-5689 Ph: (312) 429-6506 |
| NPI Number | 1477409829 |
|---|---|
| Provider Enumeration Date | 03/09/2026 |
| Last Update Date | 03/09/2026 |
| Certification Date | 03/09/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477409829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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