OrganizationActive
Edp of Wisconsin, Sc
NPI 1962961672 · Dental Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1962961672
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Edp of Wisconsin, Sc
- Organization subpart
- Yes
- Authorized official
- Roseanne Brunenkant, Director of Integrations(312) 937-3619
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
141 W Jackson Blvd
Chicago, IL 60604-2992
Phone: (312) 937-3619
Street-level locationGet directions
Mailing address
141 W Jackson Blvd Ste 210
Chicago, IL 60604-3048
Other names (DBA / former)
- Doing business as
- Elite Dental Partners
- Doing business as
- Parkside West Dental
Additional practice locations (1)
- 655 Deerwood AveNeenah, WI 54956-1629Phone: (312) 800-1270
Registry dates
- Enumerated
- 2019-03-13
- Last updated
- 2019-09-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.