Provider Demographics
NPI:1467527788
Name:VRAVICK, JOHN ALLAN (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALLAN
Last Name:VRAVICK
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 PHILLIP ROAD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1730
Mailing Address - Country:US
Mailing Address - Phone:847-680-6900
Mailing Address - Fax:847-680-6905
Practice Address - Street 1:10 PHILLIP ROAD
Practice Address - Street 2:SUITE 112
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1730
Practice Address - Country:US
Practice Address - Phone:847-680-6900
Practice Address - Fax:847-680-6905
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63131223P0300X
IL0210015151223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics