Provider Demographics
NPI:1881228161
Name:ZIMMER, JACQUELINE LEE PILESKI (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:LEE PILESKI
Last Name:ZIMMER
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 1:70 S CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-7341
Mailing Address - Country:US
Mailing Address - Phone:630-896-5400
Mailing Address - Fax:630-896-0861
Practice Address - Street 1:70 S CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-7341
Practice Address - Country:US
Practice Address - Phone:630-896-5400
Practice Address - Fax:630-896-0861
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL090242371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics