Healthcare Provider Details

I. General information

NPI: 1093290181
Provider Name (Legal Business Name): ROMO DENTAL II, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6857 S PULASKI RD
CHICAGO IL
60629-4151
US

IV. Provider business mailing address

6857 S PULASKI RD
CHICAGO IL
60629-4151
US

V. Phone/Fax

Practice location:
  • Phone: 773-585-2255
  • Fax: 773-585-2278
Mailing address:
  • Phone: 773-585-2255
  • Fax: 773-585-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. GENARO ROMO JR.
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 773-519-1022