Provider Demographics
NPI:1669938387
Name:KARRAS, THERESA (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:
Last Name:KARRAS
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5818 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3027
Mailing Address - Country:US
Mailing Address - Phone:224-300-0480
Mailing Address - Fax:
Practice Address - Street 1:11 E CEDAR ST
Practice Address - Street 2:FLOOR 2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-6066
Practice Address - Country:US
Practice Address - Phone:312-757-5893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210029921223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics