Provider Demographics
NPI:1720746126
Name:ONIK FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:ONIK FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:ONIK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:708-941-0403
Mailing Address - Street 1:22857 LAKEVIEW ESTATES BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:640 BANKVIEW DR STE 3
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1669
Practice Address - Country:US
Practice Address - Phone:815-464-0944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental