Provider Demographics
NPI:1114128865
Name:CWIK, AARON ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:ROBERT
Last Name:CWIK
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 1:202 S GREENLEAF ST STE A
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3399
Mailing Address - Country:US
Mailing Address - Phone:847-623-2830
Mailing Address - Fax:
Practice Address - Street 1:202 S GREENLEAF ST STE A
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3399
Practice Address - Country:US
Practice Address - Phone:847-623-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL0190272901223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program