Waukegan Family Family

NPI 1023458502 - Dentist - 1223G0001X

NPI Details
NPI 1023458502
Enumeration Date 06/28/2013
Last Updated 06/28/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name MICHAEL MICHAEL
Position OWNER
Phone (847) 336-7800
Fax
Practice Location
338 S. GREENBAY RD.
WAUKEGAN IL, 60085-4850, US
Phone (847) 336-7800
Fax
Business Location
338 S. GREENBAY RD.
WAUKEGAN IL, 60085-4850, US
Phone (847) 336-7800
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019-018637
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According to our database, Waukegan Family Family NPI is 1023458502, taxonomy code is 1223G0001X and license number is 019-018637, license state is located at Illinois. Waukegan Family Family physically located at 338 S. Greenbay Rd., Waukegan IL, 60085-4850. NPI Number 1033115704 has the healthcare provider type.

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1023458502 NPI number is provided on an as is basis without warranty of any kind. 1023458502 is maintained by the National Plan & Provider Enumeration System. The contents of Waukegan Family Family are for informational purposes only.