OrganizationActive
Wicker Park Dental, Ltd
NPI 1003962192 · Dentist · Chicago, IL
Provider details
- NPI number
- 1003962192
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Nidza Alicea, Office Manager(773) 235-0980
Specialties & taxonomies
Dental Providers
- Dental Clinic/Center261QD0000X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1738 W North Ave
Chicago, IL 60622
Phone: (773) 276-5566
Fax: (773) 276-8780
Street-level locationGet directions
Mailing address
1738 W. North Ave
Chicago, IL 60622
Other names (DBA / former)
- Doing business as
- Wicker Park Dental Group
Registry dates
- Enumerated
- 2007-01-25
- Last updated
- 2009-02-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.