Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Edp of Wisconsin, SC

Organization Dental Clinic/Center · NPI 1962961672

Edp of Wisconsin, SC is a Dental Clinic/Center in Chicago, Illinois. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

141 W Jackson Blvd
Chicago, IL 60604-2992
Phone: (312) 937-3619
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 655 Deerwood Ave, Neenah, WI 54956-1629 — (312) 800-1270

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1962961672
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationEdp of Wisconsin, SC
Authorized official Roseanne Brunenkant — Director Of Integrations · (312) 937-3619
Other names Elite Dental Partners; Parkside West Dental
NPI enumeratedMarch 13, 2019
Last updated in NPPESSeptember 16, 2019
Mailing address141 W Jackson Blvd Ste 210, Chicago, IL 60604-3048

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