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NPI Code Detail

MEDICARE: JAY SWEIS D.D.S P.C

MEDICARE: JAY SWEIS 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
1122300000XDentist019028603IL

General Provider Information

NPI Number : 1558704577
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAY SWEIS D.D.S P.C
Provider Business Mailing Address
First Line : 727 RIDGEVIEW DR
Second Line :
City : MCHENRY
State : IL
Zip : 60050-7054
Country : US
Telephone Number : 773-308-5542
Fax Number :
Provider Business Practice Location Address
First Line : 2715 N CENTRAL AVE
Second Line : SUITE A
City : CHICAGO
State : IL
Zip : 60639-1351
Country : US
Telephone Number : 773-308-5542
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. JUBRAIL SWEIS
Credential : D.D.S.
Telephone Number : 773-308-5542
Provider Enumeration Date : 04/09/2013
Last Update Date : 04/09/2013

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