Provider Demographics
NPI:1366446163
Name:FIGUEROA, ALVARO A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALVARO
Middle Name:A
Last Name:FIGUEROA
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 1:666 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-1653
Mailing Address - Country:US
Mailing Address - Phone:312-563-3000
Mailing Address - Fax:312-563-2514
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:STE 425
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3836
Practice Address - Country:US
Practice Address - Phone:312-563-3000
Practice Address - Fax:312-563-2514
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190189361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019018936Medicaid
IL80007361OtherBCBS # INDIVIDUAL
IL32517OtherBCBS # RCFC
IL32517OtherBCBS # RCFC
IL019018936Medicaid
IL80007361OtherBCBS # INDIVIDUAL