Healthcare Provider Details

I. General information

NPI: 1588367817
Provider Name (Legal Business Name): BARTLETT IMPLANTS & DENTURES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 ILLINOIS RTE 59
BARTLETT IL
60103
US

IV. Provider business mailing address

981 S IL ROUTE 59
BARTLETT IL
60103
US

V. Phone/Fax

Practice location:
  • Phone: 630-289-5522
  • Fax:
Mailing address:
  • Phone: 630-289-5522
  • Fax:

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: KALPESH SHAM
Title or Position: OWNER/DENTIST
Credential:
Phone: 630-289-5522