Healthcare Provider Details

I. General information

NPI: 1124956388
Provider Name (Legal Business Name): CONSTANTINE ALEMIS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3929 W 95TH ST
EVERGREEN PARK IL
60805-1903
US

IV. Provider business mailing address

3929 W 95TH ST
EVERGREEN PARK IL
60805-1903
US

V. Phone/Fax

Practice location:
  • Phone: 708-493-4402
  • Fax:
Mailing address:
  • Phone: 708-493-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019036189
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: