Healthcare Provider Details

I. General information

NPI: 1164642112
Provider Name (Legal Business Name): IDALINA C GARCIA DMD, DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WEST HIGGINS ROAD SUITE 600
SOUTH BARRINGTON IL
60010
US

IV. Provider business mailing address

33 WEST HIGGINS ROAD SUITE 600
SOUTH BARRINGTON IL
60010
US

V. Phone/Fax

Practice location:
  • Phone: 847-426-9000
  • Fax: 847-426-9050
Mailing address:
  • Phone: 847-426-9000
  • Fax: 847-426-9050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019-023480
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019-023480
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: