Provider Demographics
NPI:1023183357
Name:ROSE S. BEICOS D.D.S., P.C.
Entity Type:Organization
Organization Name:ROSE S. BEICOS D.D.S., P.C.
Other - Org Name:RSB DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEICOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-573-7979
Mailing Address - Street 1:1200 HARGER RD
Mailing Address - Street 2:SUITE 820
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1805
Mailing Address - Country:US
Mailing Address - Phone:630-573-7979
Mailing Address - Fax:630-573-1300
Practice Address - Street 1:1200 HARGER RD
Practice Address - Street 2:SUITE 820
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1805
Practice Address - Country:US
Practice Address - Phone:630-573-7979
Practice Address - Fax:630-573-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190191171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty