MEDICARE: JOHN F. O'CONNELL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1184638769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN F. O'CONNELL DDS

Provider Business Mailing Address
First Line	:	930 N YORK RD
Second Line	:	SUITE 120
City	:	HINSDALE
State	:	IL
Zip	:	60521-2991
Country	:	US
Telephone Number	:	630-455-1666
Fax Number	:	630-455-1667

Provider Business Practice Location Address
First Line	:	930 N YORK RD
Second Line	:	SUITE 120
City	:	HINSDALE
State	:	IL
Zip	:	60521-2991
Country	:	US
Telephone Number	:	630-455-1666
Fax Number	:	630-455-1667

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	03/05/2008

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