Provider Demographics
NPI:1114024163
Name:ISMILECARE,P.C.
Entity Type:Organization
Organization Name:ISMILECARE,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EUNYOUNG
Authorized Official - Middle Name:EUNICE
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:847-699-4000
Mailing Address - Street 1:1600 DEMPSTER ST
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1109
Mailing Address - Country:US
Mailing Address - Phone:847-699-4000
Mailing Address - Fax:847-699-4001
Practice Address - Street 1:1600 DEMPSTER ST
Practice Address - Street 2:SUITE LL1
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1109
Practice Address - Country:US
Practice Address - Phone:847-699-4000
Practice Address - Fax:847-699-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty