Jimenez, Rosita C.

Jimenez, Rosita C. is an sole proprietor health care provider with primary practice located at 2621 S Lawndale Ave Suite B, Chicago IL 60623-4520. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Periodontics. Dental Providers / Periodontics is her primary health care specialty. Jimenez, Rosita C. can be contacted via phone (773) 762-0200.

Contact Information

Primary practice address
2621 S Lawndale Ave Suite B Chicago IL 60623-4520
Phone: (773) 762-0200
Fax: (773) 762-0201
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019.015877 Illinois
Dental Providers / Periodontics 1223P0300X 021.001004 Illinois

Profile Details

NPI number 1356412530
LBN Legal business name Jimenez, Rosita C.
Credentials PERIODONTIST
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2006
Last updated Mar 1st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356412530 NPPES
Illinois Other DWP11770 DENTAL WELLNESS PARTNERS

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