Healthcare Provider Details

I. General information

NPI: 1326662446
Provider Name (Legal Business Name): KATHLEEN BARTIK DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 W 95TH ST STE 1
HICKORY HILLS IL
60457-2727
US

IV. Provider business mailing address

8700 W 95TH ST STE 1
HICKORY HILLS IL
60457-2727
US

V. Phone/Fax

Practice location:
  • Phone: 708-430-2266
  • Fax:
Mailing address:
  • Phone: 708-430-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019035981
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: