Healthcare Provider Details

I. General information

NPI: 1881703403
Provider Name (Legal Business Name): MARK A. FERRARI D.D.S., LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N ROSELLE RD SUITE 330
SCHAUMBURG IL
60195-3176
US

IV. Provider business mailing address

1901 N ROSELLE RD SUITE 330
SCHAUMBURG IL
60195-3176
US

V. Phone/Fax

Practice location:
  • Phone: 847-884-6776
  • Fax: 847-884-6888
Mailing address:
  • Phone: 847-884-6776
  • Fax: 847-884-6888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. MARK ANTHONY FERRARI
Title or Position: PRESIDENT
Credential: DDS
Phone: 847-884-6776