Provider Demographics
NPI:1740359991
Name:JAMES P. ECONOMOS, D.D.S., P.C.
Entity type:Organization
Organization Name:JAMES P. ECONOMOS, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:ECONOMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-830-4930
Mailing Address - Street 1:106 W BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-7880
Mailing Address - Country:US
Mailing Address - Phone:630-830-4930
Mailing Address - Fax:630-830-4953
Practice Address - Street 1:106 W BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-7880
Practice Address - Country:US
Practice Address - Phone:630-830-4930
Practice Address - Fax:630-830-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19016838IL1223G0001X, 1223P0300X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty