Provider Demographics
NPI:1073611471
Name:ALWAN, RICK D (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:D
Last Name:ALWAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1292 RICKERT DR
Mailing Address - Street 2:SUITE 144
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8907
Mailing Address - Country:US
Mailing Address - Phone:630-717-8700
Mailing Address - Fax:630-717-8709
Practice Address - Street 1:1292 RICKERT DR
Practice Address - Street 2:SUITE 144
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8907
Practice Address - Country:US
Practice Address - Phone:630-717-8700
Practice Address - Fax:630-717-8709
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist