Provider Demographics
NPI:1447373097
Name:PAPPAS DURBIN, RENEE P (DDS)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:P
Last Name:PAPPAS DURBIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RENEE
Other - Middle Name:P
Other - Last Name:PAPPAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:408 CHERRY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-1095
Mailing Address - Country:US
Mailing Address - Phone:847-818-0850
Mailing Address - Fax:847-818-0850
Practice Address - Street 1:201 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-6059
Practice Address - Country:US
Practice Address - Phone:847-253-8501
Practice Address - Fax:847-253-8543
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0212441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice