Provider Demographics
NPI:1689887861
Name:ULLMANN, CHRIS P (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:P
Last Name:ULLMANN
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 1:6121 WASHINGTON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5305
Mailing Address - Country:US
Mailing Address - Phone:847-625-9897
Mailing Address - Fax:847-625-9961
Practice Address - Street 1:6121 WASHINGTON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5305
Practice Address - Country:US
Practice Address - Phone:847-625-9897
Practice Address - Fax:847-625-9961
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice