| Stephen T Jagielo Dds Pc | |
|
4913 Main St Downers Grove IL 60515-3612 | |
| (630) 969-4441 | |
| (630) 969-4480 |
| Full Name | Stephen T Jagielo Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 4913 Main St, Downers Grove, Illinois |
| Authorized Official Name and Position | Stephen T Jagielo (PRESIDENT) |
| Authorized Official Contact | 6309694441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen T Jagielo Dds Pc 4913 Main St Downers Grove IL 60515-3612 Ph: (630) 969-4441 | Stephen T Jagielo Dds Pc 4913 Main St Downers Grove IL 60515-3612 Ph: (630) 969-4441 |
| NPI Number | 1841581436 |
|---|---|
| Provider Enumeration Date | 04/29/2011 |
| Last Update Date | 04/29/2011 |
| Medicare PECOS PAC ID | 6305015702 |
|---|---|
| Medicare Enrollment ID | O20110801000454 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841581436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 021-001523 (Illinois) | Primary |
| Provider Name | Stephen T Jagielo |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1225114622 PECOS PAC ID: 8729257134 Enrollment ID: I20110801000513 |
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