|
| |
|
3235 W Addison St Suite B Chicago IL 60618-4328 | |
| (773) 451-9392 | |
| (773) 451-9398 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3235 W Addison St, Chicago, Illinois |
| Authorized Official Name and Position | Kenneth Jeremy Barker (PRESIDENT) |
| Authorized Official Contact | 7734280157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
836 W Newport Ave Apt 2 Chicago IL 60657-2569 Ph: (773) 428-0157 | 3235 W Addison St Suite B Chicago IL 60618-4328 Ph: (773) 451-9392 |
| NPI Number | 1225322993 |
|---|---|
| Provider Enumeration Date | 05/30/2011 |
| Last Update Date | 05/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225322993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027297 (Illinois) | Primary |
Portage Park Dental Associates, Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5613 W Irving Park Rd, Chicago, IL 60634 Phone: 773-286-4030 Fax: 773-736-0716 | |
Timothy M. Crowe Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 N Michigan Ave, Suite 1329, Chicago, IL 60602 Phone: 312-782-2844 Fax: 312-783-5780 | |
Sheth Dental Assoc. P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3705 E 106th St, Chicago, IL 60617 Phone: 773-978-7773 Fax: 773-978-0419 | |
Archer Family Dental Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6615 W Archer Ave, Chicago, IL 60638 Phone: 773-586-9700 | |