Healthcare Provider Details

I. General information

NPI: 1154232254
Provider Name (Legal Business Name): JOSE GUILHERME NEVES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S PAULINA ST
CHICAGO IL
60612-7210
US

IV. Provider business mailing address

606 W WISCONSIN AVE UNIT 601
MILWAUKEE WI
53203-1927
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-7555
  • Fax:
Mailing address:
  • Phone: 414-595-8058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number136.000289
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: