Healthcare Provider Details

I. General information

NPI: 1720475981
Provider Name (Legal Business Name): MARIA KARRAS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5818 DEMPSTER ST
MORTON GROVE IL
60053-3027
US

IV. Provider business mailing address

5818 DEMPSTER ST
MORTON GROVE IL
60053-3027
US

V. Phone/Fax

Practice location:
  • Phone: 847-677-6647
  • Fax: 847-677-6906
Mailing address:
  • Phone: 847-677-6647
  • Fax: 847-677-6906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number019.030271
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number019.030271
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: