MEDICARE: CHICAGO DENTAL CARE INC

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	19023088	IL

General Provider Information

NPI Number	:	1982875563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO DENTAL CARE INC

Provider Business Mailing Address
First Line	:	7122 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2408
Country	:	US
Telephone Number	:	773-274-9009
Fax Number	:	773-274-9009

Provider Business Practice Location Address
First Line	:	7122 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2408
Country	:	US
Telephone Number	:	773-274-9009
Fax Number	:	773-274-9009

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HOSSEIN ARAGHI
Credential	:	DMD
Telephone Number	:	773-274-9009

Provider Enumeration Date	:	03/21/2008
Last Update Date	:	03/21/2008

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Directions to “CHICAGO DENTAL CARE INC ” Practice Location

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