Healthcare Provider Details

I. General information

NPI: 1902997604
Provider Name (Legal Business Name): PATRICIA ROSE VARCO-WHITE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 W HIGGINS RD SUITE 216
ROSEMONT IL
60018-3706
US

IV. Provider business mailing address

407 N MERRILL ST
PARK RIDGE IL
60068-3401
US

V. Phone/Fax

Practice location:
  • Phone: 847-390-6099
  • Fax: 847-390-6165
Mailing address:
  • Phone: 847-518-8478
  • Fax: 847-518-8478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: