Healthcare Provider Details

I. General information

NPI: 1386435832
Provider Name (Legal Business Name): SONRISA ARLINGTON HEIGHTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1768 W ALGONQUIN RD
ARLINGTON HEIGHTS IL
60005-3405
US

IV. Provider business mailing address

3520 S MORGAN ST STE 207
CHICAGO IL
60609-1533
US

V. Phone/Fax

Practice location:
  • Phone: 312-722-6460
  • Fax: 312-893-2275
Mailing address:
  • Phone: 312-722-6460
  • Fax: 312-893-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON K KORKUS
Title or Position: OWNER
Credential: DDS
Phone: 312-925-0042