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General NPI Number Information
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NPI Number | 1679631212
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Entity Type | Individual
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Provider Name | DENISE LYNN MCALLISTER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 11/09/2020
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Provider Practice Location Address
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Address Line | 888 BUSSE HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-5901
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Country | US
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Telephone | 847-518-9025
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Fax | 847-518-9027
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Provider Business Mailing Address
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Address Line | 888 BUSSE HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-5901
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Country | US
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Telephone | 847-518-9025
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Fax | 847-518-9027
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 021-001902
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 019024244
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License Number State | IL
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