Healthcare Provider Details

I. General information

NPI: 1740359991
Provider Name (Legal Business Name): JAMES P. ECONOMOS, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W BARTLETT AVE
BARTLETT IL
60103-7880
US

IV. Provider business mailing address

106 W BARTLETT AVE
BARTLETT IL
60103-7880
US

V. Phone/Fax

Practice location:
  • Phone: 630-830-4930
  • Fax: 630-830-4953
Mailing address:
  • Phone: 630-830-4930
  • Fax: 630-830-4953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19016838IL
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number19016838IL
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number19016838IL
License Number StateIL

VIII. Authorized Official

Name: DR. JAMES PETER ECONOMOS
Title or Position: OWNER
Credential: D.D.S.
Phone: 630-830-4930