Provider Demographics
NPI:1982875563
Name:CHICAGO DENTAL CARE INC
Entity Type:Organization
Organization Name:CHICAGO DENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:773-274-9009
Mailing Address - Street 1:7122 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-2408
Mailing Address - Country:US
Mailing Address - Phone:773-274-9009
Mailing Address - Fax:773-274-9009
Practice Address - Street 1:7122 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-2408
Practice Address - Country:US
Practice Address - Phone:773-274-9009
Practice Address - Fax:773-274-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19023088122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty