Provider Demographics
NPI:1073730131
Name:BOCK, ANOKHI DALIA (DMD , MSD)
Entity Type:Individual
Prefix:
First Name:ANOKHI
Middle Name:DALIA
Last Name:BOCK
Suffix:
Gender:F
Credentials:DMD , MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 S WAUKEGAN RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2608
Mailing Address - Country:US
Mailing Address - Phone:847-615-5437
Mailing Address - Fax:847-615-2955
Practice Address - Street 1:840 S WAUKEGAN RD
Practice Address - Street 2:SUITE 107
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2608
Practice Address - Country:US
Practice Address - Phone:847-615-5437
Practice Address - Fax:847-615-2955
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210021501223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry