Provider Demographics
NPI:1346066453
Name:VASU SMILES PLLC
Entity type:Organization
Organization Name:VASU SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-707-5148
Mailing Address - Street 1:13940 S AUTUMN WAY UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-8837
Mailing Address - Country:US
Mailing Address - Phone:708-707-5148
Mailing Address - Fax:
Practice Address - Street 1:470 25TH AVE
Practice Address - Street 2:
Practice Address - City:BELLWOOD
Practice Address - State:IL
Practice Address - Zip Code:60104-1961
Practice Address - Country:US
Practice Address - Phone:630-301-2932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-23
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental