MEDICARE: STEVEN KAHN D.D.S. P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019.01385	IL
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	021.000931	IL

General Provider Information

NPI Number	:	1003140187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN KAHN D.D.S. P.C.

Provider Business Mailing Address
First Line	:	25 EAST WASHINGTON ST.
Second Line	:	SUITE 1823
City	:	CHICAGO
State	:	IL
Zip	:	60602-1833
Country	:	US
Telephone Number	:	312-269-0100
Fax Number	:	312-269-0004

Provider Business Practice Location Address
First Line	:	25 EAST WASHINGTON STREET
Second Line	:	SUITE 1823
City	:	CHICAGO
State	:	IL
Zip	:	60602-1833
Country	:	US
Telephone Number	:	312-269-0100
Fax Number	:	312-269-0004

Authorized Official
Title or Position	:	ORAL SURGEON
Name	:	DR. STEVEN KAHN
Credential	:
Telephone Number	:	312-269-0100

Provider Enumeration Date	:	09/23/2009
Last Update Date	:	12/08/2009

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