Provider Demographics
NPI:1861415531
Name:CHIARA, VINCENT ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:ANTHONY
Last Name:CHIARA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 LAKE COOK RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-5646
Mailing Address - Country:US
Mailing Address - Phone:847-444-1111
Mailing Address - Fax:847-444-1115
Practice Address - Street 1:420 LAKE COOK RD
Practice Address - Street 2:SUITE 110
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5646
Practice Address - Country:US
Practice Address - Phone:847-444-1111
Practice Address - Fax:847-444-1115
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice