Timothy L. Straka D.d.s., L.l.c.

NPI 1205132925 - Dentist - 122300000X

NPI Details
NPI 1205132925
Enumeration Date 01/27/2011
Last Updated 01/27/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name TIMOTHY LARS TIMOTHY
Position MEMBER
Phone (847) 360-8450
Fax
Practice Location
2409 W WARREN BLVD
CHICAGO IL, 60612-2115, US
Phone (847) 360-8450
Fax
Business Location
2409 W WARREN BLVD
CHICAGO IL, 60612-2115, US
Phone (847) 360-8450
Fax
Toxanomy
Taxonomy Code 122300000X
License State Illinois
License Number 019018122
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According to our database, Timothy L. Straka D.d.s., L.l.c. NPI is 1205132925, taxonomy code is 122300000X and license number is 019018122, license state is located at Illinois. Timothy L. Straka D.d.s., L.l.c. physically located at 2409 W Warren Blvd, Chicago IL, 60612-2115. NPI Number 1033115704 has the healthcare provider type.

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1205132925 NPI number is provided on an as is basis without warranty of any kind. 1205132925 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy L. Straka D.d.s., L.l.c. are for informational purposes only.