Provider Demographics
NPI:1366842247
Name:BACHINSKI, KATHRYN KOVATCH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:KOVATCH
Last Name:BACHINSKI
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 1:680 W BOUGHTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2185
Mailing Address - Country:US
Mailing Address - Phone:630-759-0077
Mailing Address - Fax:
Practice Address - Street 1:680 W BOUGHTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2185
Practice Address - Country:US
Practice Address - Phone:630-759-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190300161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice