Provider Demographics
NPI:1447272778
Name:STILES, RICHARD LEO (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEO
Last Name:STILES
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 1:1645 S RIVER RD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-2206
Mailing Address - Country:US
Mailing Address - Phone:847-299-4811
Mailing Address - Fax:847-299-4379
Practice Address - Street 1:1645 S RIVER RD
Practice Address - Street 2:SUITE 21
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-2206
Practice Address - Country:US
Practice Address - Phone:847-299-4811
Practice Address - Fax:847-299-4379
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026711122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist