Healthcare Provider Details

I. General information

NPI: 1134649312
Provider Name (Legal Business Name): STEVEN JAMAAL KEGLAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 MEACHAM RD STE 12
ELK GROVE VILLAGE IL
60007-3073
US

IV. Provider business mailing address

4072 VICTORIA DR
HOFFMAN ESTATES IL
60192-1755
US

V. Phone/Fax

Practice location:
  • Phone: 224-758-0181
  • Fax:
Mailing address:
  • Phone: 317-413-2425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2017017251
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019.031296
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: