Provider Demographics
NPI:1982053252
Name:BICI, EVA (DMD)
Entity Type:Individual
Prefix:MISS
First Name:EVA
Middle Name:
Last Name:BICI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 N ORLEANS ST APT 1003
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7549
Mailing Address - Country:US
Mailing Address - Phone:312-282-3381
Mailing Address - Fax:
Practice Address - Street 1:1254 N WELLS ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-1981
Practice Address - Country:US
Practice Address - Phone:312-337-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.030673122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist