Healthcare Provider Details

I. General information

NPI: 1528477452
Provider Name (Legal Business Name): PAUL EDWARD DIFRANCO DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S PARK BLVD
GLEN ELLYN IL
60137-6211
US

IV. Provider business mailing address

10059 S ROBERTS RD STE 2A
PALOS HILLS IL
60465-1560
US

V. Phone/Fax

Practice location:
  • Phone: 630-348-9888
  • Fax:
Mailing address:
  • Phone: 708-930-5941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number019.027901
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number021.002577
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: