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General NPI Number Information
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NPI Number | 1467526624
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Entity Type | Individual
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Provider Name | NIKI RIMBAS LASKARIS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 832 BUSSE HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-2302
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Country | US
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Telephone | 847-823-6400
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Fax | 847-823-1168
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Provider Business Mailing Address
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Address Line | 832 BUSSE HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-2302
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Country | US
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Telephone | 847-823-6400
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Fax | 847-823-1168
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019-021265
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License Number State | IL
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