Healthcare Provider Details

I. General information

NPI: 1831036680
Provider Name (Legal Business Name): KEVIN REARDON DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 S SPRING RD
ELMHURST IL
60126-3857
US

IV. Provider business mailing address

479 S SPRING RD
ELMHURST IL
60126-3857
US

V. Phone/Fax

Practice location:
  • Phone: 630-834-1218
  • Fax:
Mailing address:
  • Phone: 630-834-1218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN REARDON
Title or Position: OWNER, DENTIST
Credential: DDS
Phone: 630-834-1218