Provider Demographics
NPI:1093231466
Name:PAULO, VALERIE FLORENCE (DMD)
Entity Type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:FLORENCE
Last Name:PAULO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 N PEORIA ST APT 3N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-7326
Mailing Address - Country:US
Mailing Address - Phone:630-632-0296
Mailing Address - Fax:
Practice Address - Street 1:39 E COLORADO AVE
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1385
Practice Address - Country:US
Practice Address - Phone:708-789-9289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-031352122300000X
IL0190313521223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist