Healthcare Provider Details

I. General information

NPI: 1578299418
Provider Name (Legal Business Name): GELENA ROYTMAN DDS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 TOWNLINE RD
MUNDELEIN IL
60060-4225
US

IV. Provider business mailing address

362 TOWNLINE RD
MUNDELEIN IL
60060-4225
US

V. Phone/Fax

Practice location:
  • Phone: 847-566-8585
  • Fax:
Mailing address:
  • Phone: 847-566-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: GELENA ROYTMAN
Title or Position: OWNER
Credential:
Phone: 847-566-8585