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NPI Code Detail

MEDICARE: JOHN J. DZAKOVICH DDS LTD.

MEDICARE: JOHN J. DZAKOVICH DDS LTD.
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
1251K00000XPublic Health or Welfare Agency019-0016695IL

General Provider Information

NPI Number : 1548435654
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN J. DZAKOVICH DDS LTD.
Provider Business Mailing Address
First Line : 1608 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-3908
Country : US
Telephone Number : 847-255-4889
Fax Number : 847-255-4834
Provider Business Practice Location Address
First Line : 1608 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-3908
Country : US
Telephone Number : 847-255-4889
Fax Number : 847-255-4834
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. KATHY BLAIR
Credential :
Telephone Number : 847-255-4889
Provider Enumeration Date : 04/29/2008
Last Update Date : 04/29/2008

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