Provider Demographics
NPI:1063550952
Name:REYNOLDS-INCARDONA
Entity type:Organization
Organization Name:REYNOLDS-INCARDONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:INCARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-392-7947
Mailing Address - Street 1:3325 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 600-B
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1582
Mailing Address - Country:US
Mailing Address - Phone:847-392-7947
Mailing Address - Fax:847-392-5275
Practice Address - Street 1:3325 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 600-B
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1582
Practice Address - Country:US
Practice Address - Phone:847-392-7947
Practice Address - Fax:847-392-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty