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PRO DENTAL IL - CHAD WISE PC
NPI 1023845302
Dentist - General Practice in Chicago, IL

Active since September 19, 2024
712 E 87TH ST STE D, CHICAGO, IL 60619(773) 783-9000(773) 994-0067 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pro Dental Il - Chad Wise Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRO DENTAL IL - CHAD WISE PC (NPI 1023845302), doing business as Destiny Dental Of Chatham, is a healthcare organization registered as a general practice in Chicago, Illinois and active in the NPI registry since September 2024. The organization lists Simone Wilson-adeleke, Director Of Credentialing, as its authorized official.

NPPES Registry Identity

NPI1023845302
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePRO DENTAL IL - CHAD WISE PC
Location Address712 E 87TH ST STE DChicago, IL 60619-6246
Mailing Address10 Woodbridge Center Dr Ste 520Woodbridge, NJ 07095-1152 · (732) 731-8398
Phone(773) 783-9000
Fax(773) 994-0067
Organization SubpartNo
Authorized OfficialSimone Wilson-adelekeDirector Of Credentialing · (732) 731-8398
Enumeration DateSeptember 19, 2024
NPPES CertifiedSeptember 19, 2024
✔ NPI 1023845302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
712 E 87TH ST STE D, Chicago, IL 60619
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Other Names 1

Doing Business AsDestiny Dental Of Chatham

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pro Dental Il - Chad Wise PC's NPI number?

The NPI number for Pro Dental Il - Chad Wise PC is 1023845302. It was assigned to this organization in the NPPES registry on September 19, 2024. The provider is doing business as Destiny Dental of Chatham.

Where is Pro Dental Il - Chad Wise PC located?

Pro Dental Il - Chad Wise PC is located at 712 E 87th St Ste D, Chicago, IL 60619. The listed phone number is (773) 783-9000.

What is Pro Dental Il - Chad Wise PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Pro Dental Il - Chad Wise PC was last updated on September 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.