Provider Demographics
NPI:1235305681
Name:ACDI CHICAGO LLC
Entity Type:Organization
Organization Name:ACDI CHICAGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZUZANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-586-9483
Mailing Address - Street 1:625 N MICHIGAN AVE
Mailing Address - Street 2:SUITE #1710
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3110
Mailing Address - Country:US
Mailing Address - Phone:312-440-9200
Mailing Address - Fax:312-867-0865
Practice Address - Street 1:625 N MICHIGAN AVE
Practice Address - Street 2:SUITE #1710
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3110
Practice Address - Country:US
Practice Address - Phone:312-440-9200
Practice Address - Fax:312-867-0865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190135831223G0001X
IL019.0278841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty