Periodontics Ltd. | |
4711 Golf Rd Ste 101 Skokie IL 60076-1239 | |
(847) 675-7555 | |
(847) 675-3734 |
Full Name | Periodontics Ltd. |
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Speciality | Dentist - Periodontics |
Location | 4711 Golf Rd Ste 101, Skokie, Illinois |
Authorized Official Name and Position | Stephen P Russo (PARTNER) |
Authorized Official Contact | 8476757555 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Periodontics Ltd. 4711 Golf Rd Ste 101 Skokie IL 60076-1239 Ph: (847) 675-7555 | Periodontics Ltd. 4711 Golf Rd Ste 101 Skokie IL 60076-1239 Ph: (847) 675-7555 |
NPI Number | 1043344492 |
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Provider Enumeration Date | 03/16/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043344492 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0300X | Dentist - Periodontics | (Illinois) | Primary |
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