Provider Demographics
NPI:1831611128
Name:SCHWABE, KELLY ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANNE
Last Name:SCHWABE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 HOBSON RD STE 240
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8138
Mailing Address - Country:US
Mailing Address - Phone:630-369-0101
Mailing Address - Fax:
Practice Address - Street 1:1220 HOBSON RD STE 240
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8138
Practice Address - Country:US
Practice Address - Phone:630-369-0101
Practice Address - Fax:630-369-0431
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.034149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist