MEDICARE: DR. GREGORY MICHAEL KARR DDS

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	01919004	IL

General Provider Information

NPI Number	:	1740351949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY MICHAEL KARR DDS

Provider Business Mailing Address
First Line	:	431 SUMMIT ST
Second Line	:	SUITE 105
City	:	ELGIN
State	:	IL
Zip	:	60120-3861
Country	:	US
Telephone Number	:	847-742-6717
Fax Number	:	847-742-3951

Provider Business Practice Location Address
First Line	:	431 SUMMIT ST
Second Line	:	SUITE 105
City	:	ELGIN
State	:	IL
Zip	:	60120-3861
Country	:	US
Telephone Number	:	847-742-6717
Fax Number	:	847-742-3951

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2006
Last Update Date	:	07/08/2007

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