Provider Demographics
NPI:1740807387
Name:MIGUS, KAROLINA MARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAROLINA
Middle Name:MARIA
Last Name:MIGUS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-2535
Mailing Address - Country:US
Mailing Address - Phone:224-532-7301
Mailing Address - Fax:
Practice Address - Street 1:1120 E CENTRAL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3220
Practice Address - Country:US
Practice Address - Phone:847-890-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190327091223G0001X
CT13105390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1223G0001XDental ProvidersDentistGeneral Practice