Unknown Individual – Dentist, NPI 1457475287
Dentist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
6316 WALKUP LANE
CRYSTAL LAKE, IL 60012
Phone: (815) 459-8491
Type: Mailing
2634 GRAND AVENUE, #106
WAUKEGAN, IL 60085
Phone: (847) 662-7588
Fax: (847) 662-3843
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60012)
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