Provider Demographics
NPI:1326937285
Name:SMALL, CHASE (DMD)
Entity type:Individual
Prefix:DR
First Name:CHASE
Middle Name:
Last Name:SMALL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 N CLAREMONT AVE APT 3L
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4843
Mailing Address - Country:US
Mailing Address - Phone:224-234-7278
Mailing Address - Fax:
Practice Address - Street 1:100 W HIGGINS RD UNIT L75
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9424
Practice Address - Country:US
Practice Address - Phone:630-497-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0361421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice