Provider Demographics
NPI:1699891960
Name:KIDONAKIS, EVELYN (DDS)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:KIDONAKIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 PATRIOT BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8075
Mailing Address - Country:US
Mailing Address - Phone:847-440-3331
Mailing Address - Fax:847-486-0333
Practice Address - Street 1:2640 PATRIOT BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8075
Practice Address - Country:US
Practice Address - Phone:847-440-3331
Practice Address - Fax:847-486-0333
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0216421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice