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

Modern Dental of Logan Square LLC

Organization General Practice Dentistry · NPI 1639625437

Modern Dental of Logan Square LLC is a General Practice Dentistry in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2645 N Milwaukee
Chicago, IL 60647
Phone: (773) 717-5509
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 019026403 (IL)

Record details

NPI number1639625437
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phillip Palella — Owner · (773) 489-5700
NPI enumeratedAugust 31, 2016
Last updated in NPPESAugust 31, 2016
Mailing address2037 W Division, Chicago, IL 60622

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