Provider Demographics
NPI:1346867553
Name:LAPORTE PARKER, JANE KATHRYN (DDS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:KATHRYN
Last Name:LAPORTE PARKER
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 1:1111 N MILWAUKEE AVE UNIT 361
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1661
Mailing Address - Country:US
Mailing Address - Phone:952-457-4512
Mailing Address - Fax:
Practice Address - Street 1:4 S NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-6231
Practice Address - Country:US
Practice Address - Phone:847-358-7282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.034026122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist