Provider Demographics
NPI:1871648972
Name:THURMAN, OLGA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:L
Last Name:THURMAN
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 1:34484 N US HIGHWAY 45 STE C
Mailing Address - Street 2:
Mailing Address - City:THIRD LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-4038
Mailing Address - Country:US
Mailing Address - Phone:224-541-4066
Mailing Address - Fax:847-752-8425
Practice Address - Street 1:34484 N US HIGHWAY 45 STE C
Practice Address - Street 2:
Practice Address - City:THIRD LAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-4038
Practice Address - Country:US
Practice Address - Phone:224-541-4066
Practice Address - Fax:847-752-8425
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190270651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice