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General NPI Number Information
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NPI Number | 1811433642
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Entity Type | Organization
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Legal Business Name | AHN ORTHODONTICS, INC
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 430 MILWAUKEE AVE STE 203
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3015
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Country | US
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Telephone | 847-282-0279
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Fax |
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Provider Business Mailing Address
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Address Line | 430 MILWAUKEE AVE STE 203
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EUN JEONG AHN
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Credential |
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Telephone | 847-282-0279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 021002473
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License Number State | IL
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