Healthcare Provider Details

I. General information

NPI: 1891915914
Provider Name (Legal Business Name): FAITH ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 IRVING PARK RD 202
HANOVER PARK IL
60133
US

IV. Provider business mailing address

1645 IRVING PARK RD 202
HANOVER PARK IL
60133
US

V. Phone/Fax

Practice location:
  • Phone: 630-837-5156
  • Fax: 630-837-5156
Mailing address:
  • Phone: 630-837-5156
  • Fax: 630-837-5156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. PETER ERNEST FAITH
Title or Position: OWNER
Credential: DDS
Phone: 630-837-5156