MEDICARE: ROBERT S. SALK D.D.S. JACK A. MARKS D.D.S. L.T.D.

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	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1033225040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT S. SALK D.D.S. JACK A. MARKS D.D.S. L.T.D.

Provider Business Mailing Address
First Line	:	25 E WASHINGTON ST
Second Line	:	SUITE 1707
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-263-7200
Fax Number	:	312-263-7223

Provider Business Practice Location Address
First Line	:	25 E WASHINGTON ST
Second Line	:	SUITE 1707
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-263-7200
Fax Number	:	312-263-7223

Authorized Official
Title or Position	:	PARTNER AND CORPORATE SECRETARY
Name	:	DR. REID SIGMAN
Credential	:	D.D.S.
Telephone Number	:	312-263-7200

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/22/2020

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