Healthcare Provider Details

I. General information

NPI: 1124359575
Provider Name (Legal Business Name): KWON DENTAL CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 W NORTHWEST HWY
PALATINE IL
60067-3550
US

IV. Provider business mailing address

177 W NORTHWEST HWY
PALATINE IL
60067-3550
US

V. Phone/Fax

Practice location:
  • Phone: 847-991-0903
  • Fax: 847-991-0832
Mailing address:
  • Phone: 847-991-0903
  • Fax: 847-991-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number019026324
License Number StateIL

VIII. Authorized Official

Name: DR. JAMES IKJAE KWON
Title or Position: OWNER/ DENTIST
Credential: DDS
Phone: 847-991-0903