Healthcare Provider Details

I. General information

NPI: 1538043005
Provider Name (Legal Business Name): SYDNEY PATTERSON DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9119 S EXCHANGE AVE
CHICAGO IL
60617-4225
US

IV. Provider business mailing address

3434 W 74TH ST
CHICAGO IL
60629-3518
US

V. Phone/Fax

Practice location:
  • Phone: 773-768-5000
  • Fax:
Mailing address:
  • Phone: 773-710-8939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019.036380
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: