Provider Demographics
NPI:1356578140
Name:ACDI GLENVIEW,LLC.
Entity type:Organization
Organization Name:ACDI GLENVIEW,LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FANACIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ZUZANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-571-2500
Mailing Address - Street 1:2501 COMPASS RD
Mailing Address - Street 2:130
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8000
Mailing Address - Country:US
Mailing Address - Phone:847-730-3726
Mailing Address - Fax:847-730-3734
Practice Address - Street 1:2000 SPRING RD
Practice Address - Street 2:600
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1804
Practice Address - Country:US
Practice Address - Phone:630-571-2500
Practice Address - Fax:630-571-7100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0135831223G0001X
IL019-0273111223G0001X
IL019-0205801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty