Healthcare Provider Details

I. General information

NPI: 1790122620
Provider Name (Legal Business Name): ANN MARIE REDMOND D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2013
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 E 22ND ST STE 201
LOMBARD IL
60148-6105
US

IV. Provider business mailing address

2 E 22ND ST STE 201
LOMBARD IL
60148-6105
US

V. Phone/Fax

Practice location:
  • Phone: 630-627-4680
  • Fax:
Mailing address:
  • Phone: 630-627-4680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019029387
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number12012246A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: