Provider Demographics
NPI:1093120917
Name:ZILIUTE, SIMONA (DDS)
Entity Type:Individual
Prefix:
First Name:SIMONA
Middle Name:
Last Name:ZILIUTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 BRENTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-3736
Mailing Address - Country:US
Mailing Address - Phone:312-933-3077
Mailing Address - Fax:
Practice Address - Street 1:13621 S ROUTE 59 UNIT 103
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-9701
Practice Address - Country:US
Practice Address - Phone:815-439-2400
Practice Address - Fax:815-439-1837
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190298551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice