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NPI Code Detail

MEDICARE: DR. AKHILA CYRIAC DDS

MEDICARE: DR. AKHILA CYRIAC 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
1122300000XDentist019033320IL

General Provider Information

NPI Number : 1619640760
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AKHILA CYRIAC DDS
Provider Business Mailing Address
First Line : 8422 W JOHANNA DR
Second Line :
City : NILES
State : IL
Zip : 60714-1851
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7037 S STONY ISLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60649-1905
Country : US
Telephone Number : 312-996-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2021
Last Update Date : 10/16/2023

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