Healthcare Provider Details

I. General information

NPI: 1558483180
Provider Name (Legal Business Name): GENTLE TOUCH FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 GINGER WOODS CT
WHEELING IL
60090-5401
US

IV. Provider business mailing address

1450 GINGER WOODS CT
WHEELING IL
60090-5401
US

V. Phone/Fax

Practice location:
  • Phone: 312-375-8860
  • Fax:
Mailing address:
  • Phone: 312-375-8860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019026416
License Number StateIL

VIII. Authorized Official

Name: DR. SIMONA ALEXANDRA CHESKIS
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 312-375-8860