MEDICARE: WILLIAM A. SEPER, 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	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1700968450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM A. SEPER, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	9661 W 143RD ST
Second Line	:	SUITE 100
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-2088
Country	:	US
Telephone Number	:	708-403-0100
Fax Number	:	708-403-8657

Provider Business Practice Location Address
First Line	:	9661 W 143RD ST
Second Line	:	SUITE 100
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-2088
Country	:	US
Telephone Number	:	708-403-0100
Fax Number	:	708-403-8657

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM ALBERT SEPER
Credential	:	D.D.S.
Telephone Number	:	708-403-0100

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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