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General NPI Number Information
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NPI Number | 1235029190
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Entity Type | Individual
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Provider Name | LAUREN WILES DMD
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Gender | Female
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 3440 OHIO ST
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City | GREAT LAKES
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State | IL
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Zip | 60088-3155
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Country | US
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Telephone | 847-688-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 210 N WELLS ST APT 4211
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City | CHICAGO
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State | IL
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Zip | 60606-2000
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Country | US
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Telephone | 412-552-8799
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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 | DS045223
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License Number State | PA
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