Provider Demographics
NPI:1538389713
Name:SEMPRUM, ADRIANA CECILIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:CECILIA
Last Name:SEMPRUM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 SOUTH MICHIGAN AVENUE
Mailing Address - Street 2:APT 805
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616
Mailing Address - Country:US
Mailing Address - Phone:312-533-4173
Mailing Address - Fax:
Practice Address - Street 1:6941 WEST ARCHER AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2330
Practice Address - Country:US
Practice Address - Phone:773-586-5040
Practice Address - Fax:773-586-5030
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist