Healthcare Provider Details

I. General information

NPI: 1316857022
Provider Name (Legal Business Name): ZEILA CECELIA DENT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 PEYTON DR
CHICAGO HEIGHTS IL
60411-1183
US

IV. Provider business mailing address

POB 1391
MATTESON IL
60443
US

V. Phone/Fax

Practice location:
  • Phone: 708-918-4751
  • Fax:
Mailing address:
  • Phone: 708-918-4751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: