Healthcare Provider Details

I. General information

NPI: 1194633487
Provider Name (Legal Business Name): MACARENA SOLEDAD MOSQUERA CAMPANA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 S STATE ROUTE 59
BARTLETT IL
60103-1670
US

IV. Provider business mailing address

825 SIENNA DR
SCHAUMBURG IL
60193-3931
US

V. Phone/Fax

Practice location:
  • Phone: 603-289-5522
  • Fax:
Mailing address:
  • Phone: 847-322-9411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019037221
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: