Healthcare Provider Details

I. General information

NPI: 1760554646
Provider Name (Legal Business Name): JAMES W. SISLOW D.D.S. LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 GRAND CANYON PKWY SUITE 117
HOFFMAN ESTATES IL
60169
US

IV. Provider business mailing address

990 GRAND CANYON PKWY SUITE 117
HOFFMAN ESTATES IL
60169
US

V. Phone/Fax

Practice location:
  • Phone: 847-843-8410
  • Fax: 847-843-9184
Mailing address:
  • Phone: 847-843-8410
  • Fax: 847-843-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30290
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. JAMES WILLIAM SISLOW
Title or Position: ORTHODONTIST
Credential: D.D.S.
Phone: 847-843-8410