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950 W Il Route 22 Suite 119 Lake Zurich IL 60047-3417 | |
| (847) 438-7252 | |
| (847) 438-7278 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 950 W Il Route 22, Lake Zurich, Illinois |
| Authorized Official Name and Position | Marc S Kaplan (OWNER) |
| Authorized Official Contact | 8474387252 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
950 W Il Route 22 Suite 119 Lake Zurich IL 60047-3417 Ph: (847) 438-7252 | 950 W Il Route 22 Suite 119 Lake Zurich IL 60047-3417 Ph: (847) 438-7252 |
| NPI Number | 1598193864 |
|---|---|
| Provider Enumeration Date | 10/24/2013 |
| Last Update Date | 12/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598193864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019021295 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 019021295 (Illinois) | Secondary |
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