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How to Join

Return the required documents by fax to 630-983-4085 or mail in the documents to begin your participation process. Our mailing address is: 

Delta Dental of Illinois
Attn: Professional Relations
111 Shuman Boulevard
Naperville, IL  60563

Please complete these forms to enroll in the Delta Dental PPOSM Network: 

PPO Enrollment Checklist
PPO Agreement
Credentialing Form
Direct Deposit

Please note: If you have any questions or would like a copy of the PPO fee schedule, please contact the Delta Dental of Illinois Professional Relations Department at or call 630-718-4990.