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General NPI Number Information
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NPI Number | 1093123226
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Entity Type | Individual
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Provider Name | REBECCA KENDRICK DDS
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Gender | Female
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 1933 FRANCISCAN WAY
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City | WEST CHICAGO
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State | IL
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Zip | 60185-6201
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Country | US
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Telephone | 630-231-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 236 S MADISON AVE
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City | LA GRANGE
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State | IL
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Zip | 60525-2342
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Country | US
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Telephone | 708-699-3967
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019029836
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License Number State | IL
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