Provider Demographics
NPI:1134416118
Name:ROSARIO SALERNO DENTAL CARE LLC
Entity type:Organization
Organization Name:ROSARIO SALERNO DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:DEFATIMA
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-334-9652
Mailing Address - Street 1:2972 ANDRUS DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5211
Mailing Address - Country:US
Mailing Address - Phone:847-334-9652
Mailing Address - Fax:
Practice Address - Street 1:1N121 COUNTY FARM RD STE 130
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-2034
Practice Address - Country:US
Practice Address - Phone:847-334-9652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025191261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental