Provider Demographics
NPI:1992803084
Name:CAMP, LLOYD ELLIOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:ELLIOTT
Last Name:CAMP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:LLOYD
Other - Middle Name:ELLIOTT
Other - Last Name:KEMPKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8725 W HIGGINS RD
Mailing Address - Street 2:SUITE 485
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2716
Mailing Address - Country:US
Mailing Address - Phone:773-329-4450
Mailing Address - Fax:773-329-4454
Practice Address - Street 1:8725 W HIGGINS RD
Practice Address - Street 2:SUITE 485
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2716
Practice Address - Country:US
Practice Address - Phone:773-329-4450
Practice Address - Fax:773-329-4454
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2741-015122300000X
IL019027709122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9214538Medicaid
WI33707900Medicaid