Provider Demographics
NPI:1932485356
Name:ZOLNIERCZYK, ERICA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:ZOLNIERCZYK
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 1:14512 JOHN HUMPHREY DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2902
Mailing Address - Country:US
Mailing Address - Phone:708-460-6699
Mailing Address - Fax:708-460-1481
Practice Address - Street 1:14512 JOHN HUMPHREY DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2902
Practice Address - Country:US
Practice Address - Phone:708-460-6699
Practice Address - Fax:708-460-1481
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190287981223G0001X
IN12011750A1223G0001X
IL019.0287981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice