Healthcare Provider Details

I. General information

NPI: 1942111620
Provider Name (Legal Business Name): DANIEL J. NICORATA, D.D.S., LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10720 W 143RD ST STE 27
ORLAND PARK IL
60462-1986
US

IV. Provider business mailing address

10720 W 143RD ST STE 27
ORLAND PARK IL
60462-1986
US

V. Phone/Fax

Practice location:
  • Phone: 708-460-1109
  • Fax: 708-460-1150
Mailing address:
  • Phone: 708-460-1109
  • Fax: 708-460-1150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DANIEL NICORATA
Title or Position: OWNER
Credential: DDS
Phone: 708-712-2584