Provider Demographics
NPI:1902586415
Name:TONARELLI, ISABELLA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ISABELLA
Middle Name:
Last Name:TONARELLI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-3987
Mailing Address - Country:US
Mailing Address - Phone:815-641-2760
Mailing Address - Fax:
Practice Address - Street 1:7170 CATON FARM RD UNIT I
Practice Address - Street 2:UNIT P
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-1695
Practice Address - Country:US
Practice Address - Phone:815-782-2299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0342271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty