Healthcare Provider Details

I. General information

NPI: 1649192998
Provider Name (Legal Business Name): GABRIELA KOBYLARZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 CANFIELD RD
PARK RIDGE IL
60068-5553
US

IV. Provider business mailing address

1017 DEVON AVE
PARK RIDGE IL
60068-4650
US

V. Phone/Fax

Practice location:
  • Phone: 847-274-1251
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.037358
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: