MEDICARE: SONRISA ARLINGTON HEIGHTS

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

General Provider Information

NPI Number	:	1891585329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SONRISA ARLINGTON HEIGHTS

Provider Business Mailing Address
First Line	:	3520 S MORGAN ST STE 207
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-1533
Country	:	US
Telephone Number	:	312-722-6460
Fax Number	:	312-893-2275

Provider Business Practice Location Address
First Line	:	1768 W ALGONQUIN RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3405
Country	:	US
Telephone Number	:	312-722-6460
Fax Number	:	312-893-2275

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JASON K KORKUS
Credential	:	DDS
Telephone Number	:	312-925-0042

Provider Enumeration Date	:	05/08/2025
Last Update Date	:	05/08/2025

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