MEDICARE: DR. ERNEST L. COSTELLO D.D.S.

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	261Q00000X	Clinic/Center	019028668	IL

General Provider Information

NPI Number	:	1841585981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNEST L. COSTELLO D.D.S.

Provider Business Mailing Address
First Line	:	1510 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3906
Country	:	US
Telephone Number	:	847-259-1111
Fax Number	:	847-259-2222

Provider Business Practice Location Address
First Line	:	1510 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3906
Country	:	US
Telephone Number	:	847-259-1111
Fax Number	:	847-259-2222

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

Provider Enumeration Date	:	06/16/2011
Last Update Date	:	12/02/2025

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