MEDICARE: MRS. ROSARIO D SALERNO D.D.S.

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	019025191	IL

General Provider Information

NPI Number	:	1427387166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSARIO D SALERNO D.D.S.

Provider Business Mailing Address
First Line	:	2972 ANDRUS DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-5211
Country	:	US
Telephone Number	:	847-334-9652
Fax Number	:	847-334-9652

Provider Business Practice Location Address
First Line	:	2972 ANDRUS DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-5211
Country	:	US
Telephone Number	:	847-334-9652
Fax Number	:	847-334-9652

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

Provider Enumeration Date	:	12/09/2009
Last Update Date	:	04/14/2020

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