Provider Demographics
NPI:1295958171
Name:ADAMS, CARY A (DENTIST)
Entity type:Individual
Prefix:DR
First Name:CARY
Middle Name:A
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 OLD ORCHARD RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077
Mailing Address - Country:US
Mailing Address - Phone:847-677-8553
Mailing Address - Fax:
Practice Address - Street 1:OLD ORCHARD PROF. BLDG.
Practice Address - Street 2:64 OLD ORCHARD ROAD, SU. 500
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077
Practice Address - Country:US
Practice Address - Phone:847-677-8553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice