MEDICARE: ACDI - OAK BROOK, LLC.

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	1223G0001X	General Practice Dentistry	019027304	IL
2	1223G0001X	General Practice Dentistry	019026703	IL
3	1223G0001X	General Practice Dentistry	019013583	IL
4	1223G0001X	General Practice Dentistry	019.027793	IL

General Provider Information

NPI Number	:	1154597813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACDI - OAK BROOK, LLC.

Provider Business Mailing Address
First Line	:	2000 SPRING RD
Second Line	:	SUITE #600
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1804
Country	:	US
Telephone Number	:	630-571-2500
Fax Number	:	630-571-7100

Provider Business Practice Location Address
First Line	:	2000 SPRING RD
Second Line	:	SUITE #600
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1804
Country	:	US
Telephone Number	:	630-571-2500
Fax Number	:	630-571-7100

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MRS. ZUZANA VITKOVA
Credential	:
Telephone Number	:	630-586-9483

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	08/07/2009

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