Provider Demographics
NPI:1972897437
Name:STROMIDLO, CHRISTOPHER E (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:E
Last Name:STROMIDLO
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 1:6950 W ARCHER AVE
Mailing Address - Street 2:UNIT 8
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2300
Mailing Address - Country:US
Mailing Address - Phone:773-229-0123
Mailing Address - Fax:
Practice Address - Street 1:6950 W ARCHER AVE
Practice Address - Street 2:UNIT 8
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2300
Practice Address - Country:US
Practice Address - Phone:773-229-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190233991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice