Healthcare Provider Details

I. General information

NPI: 1831340512
Provider Name (Legal Business Name): MARIA-MARCIA ARAUJO CARVALHO D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5919 W CERMAK RD
CICERO IL
60804-2136
US

IV. Provider business mailing address

479 N HARLEM AVE APT 1324
OAK PARK IL
60301-6419
US

V. Phone/Fax

Practice location:
  • Phone: 708-222-6600
  • Fax:
Mailing address:
  • Phone: 312-608-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019027787
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN24012
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: