Provider Demographics
NPI:1184766263
Name:SILC, JENNIFER T (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:T
Last Name:SILC
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 1:955 N. PLUM GROVE RD. STE E
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-605-0280
Mailing Address - Fax:847-605-0288
Practice Address - Street 1:955 N. PLUM GROVE RD. STE E
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-605-0280
Practice Address - Fax:847-605-0288
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027551122300000X
MI179721223P0300X
IL0210022551223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist