Provider Demographics
NPI:1871707281
Name:CARUSO, JOSEPH LOUIS (DDS MS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LOUIS
Last Name:CARUSO
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:107 E KENILWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60070-1314
Mailing Address - Country:US
Mailing Address - Phone:847-707-9977
Mailing Address - Fax:847-398-5766
Practice Address - Street 1:676 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2883
Practice Address - Country:US
Practice Address - Phone:312-274-3333
Practice Address - Fax:312-274-3334
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics