| Northshore Center For Sleep Dentistry, Ltd | |
|
6314 N Lincoln Ave Chicago IL 60659-1204 | |
| (773) 509-0029 | |
| (773) 509-0733 |
| Full Name | Northshore Center For Sleep Dentistry, Ltd |
|---|---|
| Speciality | Dentist |
| Location | 6314 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Paul Saniuk (PRESIDENT) |
| Authorized Official Contact | 7735090029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Center For Sleep Dentistry, Ltd 6314 N Lincoln Ave Chicago IL 60659-1204 Ph: (773) 509-0029 | Northshore Center For Sleep Dentistry, Ltd 6314 N Lincoln Ave Chicago IL 60659-1204 Ph: (773) 509-0029 |
| NPI Number | 1013313907 |
|---|---|
| Provider Enumeration Date | 11/05/2014 |
| Last Update Date | 02/10/2021 |
| Medicare PECOS PAC ID | 0749549806 |
|---|---|
| Medicare Enrollment ID | O20181213001782 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013313907 | NPI | - | NPPES |
| 019017944 | Other | IL | LICENSED DENTIST |
| 1073655213 | Other | IL | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019017944 (Illinois) | Primary |
| Provider Name | Paul Saniuk |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1073655213 PECOS PAC ID: 7416277835 Enrollment ID: I20181213001945 |
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