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General NPI Number Information
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NPI Number | 1154597813
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Entity Type | Organization
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Legal Business Name | ACDI - OAK BROOK, LLC.
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 08/07/2009
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Provider Practice Location Address
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Address Line | 2000 SPRING RD SUITE #600
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City | OAK BROOK
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State | IL
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Zip | 60523-1804
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Country | US
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Telephone | 630-571-2500
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Fax | 630-571-7100
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Provider Business Mailing Address
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Address Line | 2000 SPRING RD SUITE #600
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City | OAK BROOK
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State | IL
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Zip | 60523-1804
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Country | US
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Telephone | 630-571-2500
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Fax | 630-571-7100
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. ZUZANA VITKOVA
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Credential |
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Telephone | 630-586-9483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019027304
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019026703
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019013583
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.027793
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License Number State | IL
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