Provider Demographics
NPI:1851469415
Name:RZAZEWSKA-JOHNSON, RENATA (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:RENATA
Middle Name:
Last Name:RZAZEWSKA-JOHNSON
Suffix:
Gender:F
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 COMPASS RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8045
Mailing Address - Country:US
Mailing Address - Phone:847-998-6262
Mailing Address - Fax:
Practice Address - Street 1:2551 COMPASS RD
Practice Address - Street 2:SUITE 125
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8045
Practice Address - Country:US
Practice Address - Phone:847-998-6262
Practice Address - Fax:847-998-6237
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics