Provider Demographics
NPI:1457346272
Name:PERKINSON, WILLIAM L (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:PERKINSON
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 1:345 SULLIVAN RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1465
Mailing Address - Country:US
Mailing Address - Phone:630-892-1515
Mailing Address - Fax:630-892-1583
Practice Address - Street 1:345 SULLIVAN RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1465
Practice Address - Country:US
Practice Address - Phone:630-892-1515
Practice Address - Fax:630-892-1583
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190251641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
V01075Medicare UPIN
ILK09265Medicare ID - Type Unspecified
ILK09263Medicare ID - Type Unspecified
ILK09262Medicare ID - Type Unspecified
ILK09264Medicare ID - Type Unspecified