MEDICARE: KEVIN REARDON DDS PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1831036680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN REARDON DDS PLLC

Provider Business Mailing Address
First Line	:	479 S SPRING RD
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-3857
Country	:	US
Telephone Number	:	630-834-1218
Fax Number	:

Provider Business Practice Location Address
First Line	:	479 S SPRING RD
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-3857
Country	:	US
Telephone Number	:	630-834-1218
Fax Number	:

Authorized Official
Title or Position	:	OWNER, DENTIST
Name	:	DR. KEVIN REARDON
Credential	:	DDS
Telephone Number	:	630-834-1218

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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