Healthcare Provider Details

I. General information

NPI: 1407804255
Provider Name (Legal Business Name): RACHEL SUSANNE CUADROS D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 BANKVIEW DR STE A
FRANKFORT IL
60423-1490
US

IV. Provider business mailing address

19160 88TH AVE
MOKENA IL
60448-8135
US

V. Phone/Fax

Practice location:
  • Phone: 708-577-5015
  • Fax: 779-254-2866
Mailing address:
  • Phone: 708-577-5015
  • Fax: 708-479-7747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019-025010
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: