MEDICARE: DENTAL 360 PULASKI 67 LLC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1356170690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL 360 PULASKI 67 LLC

Provider Business Mailing Address
First Line	:	2756 W CERMAK RD STE B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3528
Country	:	US
Telephone Number	:	773-247-5707
Fax Number	:	773-247-5709

Provider Business Practice Location Address
First Line	:	2756 W CERMAK RD STE B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-3528
Country	:	US
Telephone Number	:	773-247-5707
Fax Number	:	773-247-5709

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMMED PARVEZ
Credential	:
Telephone Number	:	630-294-1770

Provider Enumeration Date	:	07/26/2024
Last Update Date	:	07/26/2024

Similar Medicare Providers

1700956695 — DR. DAVID ANYADIKE M.D.
Practice Location Address:

2738 W CERMAK RD
CHICAGO, IL
60608-3528

Practice Phone: 773-376-1906
Practice Fax: 773-376-1909

1316291982 — BRITE DENTAL CERMAK, P.C.
Practice Location Address:

2756 W CERMAK RD
CHICAGO, IL
60608-3528

Practice Phone: 773-247-5707
Practice Fax: 773-247-5709

1194191965 — DR. KEITH PATEL D.M.D.
Practice Location Address:

2756 W CERMAK RD
CHICAGO, IL
60608-3528

Practice Phone: 773-247-5707
Practice Fax:

1588378988 — PILSEN-LITTLE VILLAGE COMMUNITY MENTAL HEALTH CENTER, INC.
Practice Location Address:

3528 S HERMITAGE AVE
CHICAGO, IL
60609-1217

Practice Phone: 773-579-0832
Practice Fax: 773-579-0762

1801910088 — WEST CHICAGO EL SCHOOL DIST 33
Practice Location Address:

312 E FOREST AVE
WEST CHICAGO, IL
60185-3528

Practice Phone: 630-293-6000
Practice Fax:

1811171143 — AUNT MARTHAS YOUTH SERVICE CENTER INC
Practice Location Address:

3528 E 118TH ST
CHICAGO, IL
60617-7314

Practice Phone: 708-747-7100
Practice Fax:

Directions to “DENTAL 360 PULASKI 67 LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.