| Chicagoland Implant Specialist Ltd | |
|
237 S Main St Lombard IL 60148-2647 | |
| (312) 533-8489 | |
| Not Available |
| Full Name | Chicagoland Implant Specialist Ltd |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 237 S Main St, Lombard, Illinois |
| Authorized Official Name and Position | Paul S Petrungaro (OWNER) |
| Authorized Official Contact | 3124157481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicagoland Implant Specialist Ltd 6420 N Lehigh Ave Chicago IL 60646-2704 Ph: (312) 624-9300 | Chicagoland Implant Specialist Ltd 237 S Main St Lombard IL 60148-2647 Ph: (312) 533-8489 |
| NPI Number | 1326498130 |
|---|---|
| Provider Enumeration Date | 06/13/2016 |
| Last Update Date | 01/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326498130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 021001401 (Illinois) | Primary |
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