Provider Demographics
NPI:1134291446
Name:ALBERS, THERESA MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:ALBERS
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 1:579 N 1ST BANK DR
Mailing Address - Street 2:140
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8134
Mailing Address - Country:US
Mailing Address - Phone:847-705-7690
Mailing Address - Fax:847-705-0377
Practice Address - Street 1:579 N. FIRST BANK DR.
Practice Address - Street 2:140
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:847-705-7690
Practice Address - Fax:847-705-0377
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01902288122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist