Healthcare Provider Details

I. General information

NPI: 1194995332
Provider Name (Legal Business Name): CHILDRENS DENTISTRY JOSEPH F ZUCCHERO DDS MS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 W TALCOTT SUITE 566
CHICAGO IL
60631
US

IV. Provider business mailing address

7447 W TALCOTT SUITE 566
CHICAGO IL
60631
US

V. Phone/Fax

Practice location:
  • Phone: 773-792-2347
  • Fax:
Mailing address:
  • Phone: 773-792-2347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. JOSEPH FRANCIS ZUCCHERO
Title or Position: PRESIDENT
Credential: DDS
Phone: 773-792-2347