Rasty, Mary

Rasty, Mary is an individual health care provider with primary practice located at 2400 Belvidere Rd , Waukegan IL 60085-6165. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Rasty, Mary can be contacted via phone (847) 984-5330.

Contact Information

Primary practice address
2400 Belvidere Rd Waukegan IL 60085-6165
Phone: (847) 984-5330
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019025325 Illinois

Profile Details

NPI number 1437132412
LBN Legal business name Rasty, Mary
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Dec 19th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437132412 NPPES
Illinois MEDICAID 019025325
Illinois Other 1005423

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