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General NPI Number Information
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NPI Number | 1528466547
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Entity Type | Organization
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Legal Business Name | RACHEL S. CUADROS LTD
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Dates
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Enumeration Date | 12/08/2014
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 19160 88TH AVE
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City | MOKENA
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State | IL
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Zip | 60448-8135
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Country | US
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Telephone | 708-577-5015
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Fax | 708-479-7747
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Provider Business Mailing Address
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Address Line | 19160 88TH AVE
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City | MOKENA
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State | IL
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Zip | 60448-8135
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Country | US
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Telephone | 708-577-5015
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Fax | 708-479-7747
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Authorized Official
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Title or Position | OWNER
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Name | DR. RACHEL S CUADROS
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Credential | D.D.S.
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Telephone | 708-577-5015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 019025010
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License Number State | IL
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