Provider Demographics
NPI:1942462247
Name:BEICOS, ROSE S (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSE
Middle Name:S
Last Name:BEICOS
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 1:1200 HARGER RD
Mailing Address - Street 2:820
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1805
Mailing Address - Country:US
Mailing Address - Phone:630-573-7979
Mailing Address - Fax:630-573-1300
Practice Address - Street 1:1200 HARGER RD
Practice Address - Street 2:820
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1805
Practice Address - Country:US
Practice Address - Phone:630-573-7979
Practice Address - Fax:630-573-1300
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190191171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice