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Dental Claim Form HEADER INFORMATIONSend Completed Claim Form To: Dental Claims Administrator P.O. Box 1206 Elk Grove Village, IL 6000912061. Type of Transaction (Mark all applicable boxes) Statement

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Elk Grove Village is a suburban community located in Cook and DuPage counties in Illinois, known for its residential neighborhoods, parks, and proximity to major transportation routes.

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Residents and business owners in Elk Grove Village may be required to file certain local taxes or reports based on their income, business activity, or property ownership.

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The purpose of Elk Grove Village is to provide a quality living environment for residents, support local businesses, and ensure the efficient delivery of municipal services.

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