Healthcare Provider Details

I. General information

NPI: 1457279853
Provider Name (Legal Business Name): KWARTENG ORTHODONTICS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 S WEBER RD STE D
BOLINGBROOK IL
60490-1502
US

IV. Provider business mailing address

524 APPIAN WAY
MATTESON IL
60443-1785
US

V. Phone/Fax

Practice location:
  • Phone: 630-425-2272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: LISA KWARTENG
Title or Position: PRESIDENT
Credential: DMD
Phone: 630-425-2272