Provider Demographics
NPI:1154088730
Name:CORTOPASSI, CHRISTOPHER DAVID (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:CORTOPASSI
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BOULDER HILL PASS
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-1911
Mailing Address - Country:US
Mailing Address - Phone:630-896-2779
Mailing Address - Fax:630-896-9252
Practice Address - Street 1:25 BOULDER HILL PASS
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-1911
Practice Address - Country:US
Practice Address - Phone:630-896-2779
Practice Address - Fax:630-896-9252
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0033441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty