Provider Demographics
NPI:1669667432
Name:KALKANIS, GEORGIA HELEN (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:HELEN
Last Name:KALKANIS
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 1:5333 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2121
Mailing Address - Country:US
Mailing Address - Phone:773-728-5333
Mailing Address - Fax:773-739-4300
Practice Address - Street 1:5333 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2121
Practice Address - Country:US
Practice Address - Phone:773-728-5333
Practice Address - Fax:773-739-4300
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0250831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice