Provider Demographics
NPI:1750184800
Name:METRO CHICAGO ENDODONTICS, PLLC
Entity type:Organization
Organization Name:METRO CHICAGO ENDODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:TISCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:630-686-0623
Mailing Address - Street 1:917 S BRUNER ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4384
Mailing Address - Country:US
Mailing Address - Phone:847-477-0847
Mailing Address - Fax:
Practice Address - Street 1:555 PLAINFIELD RD STE E
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7619
Practice Address - Country:US
Practice Address - Phone:630-686-0623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental