MEDICARE: BRACES TOWN PC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1881169134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRACES TOWN PC

Provider Business Mailing Address
First Line	:	3020 S CICERO AVE
Second Line	:
City	:	CICERO
State	:	IL
Zip	:	60804-3638
Country	:	US
Telephone Number	:	708-863-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 S CICERO AVE
Second Line	:
City	:	CICERO
State	:	IL
Zip	:	60804-3638
Country	:	US
Telephone Number	:	708-863-2000
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CECILIA ARTEAGA
Credential	:
Telephone Number	:	708-863-2000

Provider Enumeration Date	:	10/12/2018
Last Update Date	:	06/18/2026

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Directions to “BRACES TOWN PC ” Practice Location

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