Provider Demographics
NPI:1316150048
Name:DRACOS, WILLIAM G (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:G
Last Name:DRACOS
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 1:1026 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2054
Mailing Address - Country:US
Mailing Address - Phone:847-244-4455
Mailing Address - Fax:
Practice Address - Street 1:355 GREENLEAF AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PARK CITY
Practice Address - State:IL
Practice Address - Zip Code:60085-5708
Practice Address - Country:US
Practice Address - Phone:847-244-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist