Provider Demographics
NPI:1740708015
Name:ALI TEKDOGAN DDS ADDISON LLC
Entity type:Organization
Organization Name:ALI TEKDOGAN DDS ADDISON LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:TEKDOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-945-1050
Mailing Address - Street 1:720 OSTERMAN AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4339
Mailing Address - Country:US
Mailing Address - Phone:847-945-1050
Mailing Address - Fax:847-940-0433
Practice Address - Street 1:1001 W LAKE ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2094
Practice Address - Country:US
Practice Address - Phone:630-543-2300
Practice Address - Fax:630-543-7930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025188261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental