Carlos J Alberttis, DDS
Individual provider Active NPI Dentist · Melrose Park, IL
NPI 1043389299 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043389299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- Practice address
- 1908 W Lake St
Melrose Park, IL 60160-3728 - Phone
- (708) 345-6636
- Fax
- (708) 345-6671
- NPI assigned
- Nov 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019021046 | IL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Yes |
Addresses
Primary practice location
1908 W Lake St
Melrose Park, IL 60160-3728
Mailing address
1908 W Lake St
P.O.Box.8373
Melrose Park, IL 60160-3728
Phone (708) 345-6636
Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.