NPI 1225583776

25 East Dental LLC

Organisation Preferred Provider Organization Chicago, IL

Practice location

Address: 25 E Washington St Suite 1115, Chicago, IL 60602-1708
Phone: (630) 339-3172
Mailing address: 129 S Roselle Rd Suite 102, Schaumburg, IL 60193-5540

Authorised official

Name: Alan J Acierno
Title: Manager
Phone: (630) 339-3172

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 019018378 (IL)

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Registry record

NPI: 1225583776
Entity type: Organization
NPI issued: 24 Aug 2016
Record last updated: 24 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.