Healthcare Provider Details

I. General information

NPI: 1568550374
Provider Name (Legal Business Name): LUCIANA E. BURCA, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 04/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 N MARINE DR SUITE 304
CHICAGO IL
60640-3244
US

IV. Provider business mailing address

5030 N MARINE DR
CHICAGO IL
60640-3244
US

V. Phone/Fax

Practice location:
  • Phone: 773-447-1021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: LUCIANA E SWEIS
Title or Position: PRESIDENT
Credential: DDS
Phone: 773-506-8052