MEDICARE: 888 ORTHODONTICS, PC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry		IL

General Provider Information

NPI Number	:	1649204835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	888 ORTHODONTICS, PC

Provider Business Mailing Address
First Line	:	2043 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3935
Country	:	US
Telephone Number	:	773-348-8008
Fax Number	:

Provider Business Practice Location Address
First Line	:	2043 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3935
Country	:	US
Telephone Number	:	773-348-8008
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	DR. WILLIAM V. DOLGI
Credential	:	D.D.S., M.S.
Telephone Number	:	773-348-8008

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	08/22/2020

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