Provider Demographics
NPI:1720077068
Name:MCELROY PEDIATRIC DENISTRY, LTD.
Entity type:Organization
Organization Name:MCELROY PEDIATRIC DENISTRY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCELROY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-351-4440
Mailing Address - Street 1:231 S GARY AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2234
Mailing Address - Country:US
Mailing Address - Phone:630-351-4440
Mailing Address - Fax:630-351-0401
Practice Address - Street 1:231 S GARY AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2234
Practice Address - Country:US
Practice Address - Phone:630-351-4440
Practice Address - Fax:630-351-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty