Provider Demographics
NPI:1013285352
Name:CINCIONE, ALEXIS M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:M
Last Name:CINCIONE
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 1:2045 W CONCORD PL
Mailing Address - Street 2:#504
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5628
Mailing Address - Country:US
Mailing Address - Phone:630-254-2724
Mailing Address - Fax:
Practice Address - Street 1:5342 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4949
Practice Address - Country:US
Practice Address - Phone:773-284-1645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.027674122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist