MEDICARE: SYDNEY CHRISTINE DELGADILLO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019033182	IL

General Provider Information

NPI Number	:	1053980243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY CHRISTINE DELGADILLO DMD

Provider Business Mailing Address
First Line	:	217 MARKET ST
Second Line	:
City	:	GALVA
State	:	IL
Zip	:	61434-1766
Country	:	US
Telephone Number	:	309-932-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 11TH ST
Second Line	:
City	:	PORT BYRON
State	:	IL
Zip	:	61275-9038
Country	:	US
Telephone Number	:	309-523-3325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2021
Last Update Date	:	06/22/2021

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