Provider Demographics
NPI:1023167756
Name:RAINONE, ANGELO D (DDS)
Entity type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:D
Last Name:RAINONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7644 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4143
Mailing Address - Country:US
Mailing Address - Phone:708-453-0400
Mailing Address - Fax:708-453-0404
Practice Address - Street 1:7644 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4143
Practice Address - Country:US
Practice Address - Phone:708-453-0400
Practice Address - Fax:708-453-0404
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist