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NPI Code Detail

MEDICARE: PATRICIA J NEMEC D.D.S.

MEDICARE: PATRICIA J NEMEC D.D.S.
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
11223G0001XGeneral Practice Dentistry019026878IL

General Provider Information

NPI Number : 1881897700
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA J NEMEC D.D.S.
Provider Business Mailing Address
First Line : 416 UVEDALE RD
Second Line :
City : RIVERSIDE
State : IL
Zip : 60546-1609
Country : US
Telephone Number : 312-451-3866
Fax Number :
Provider Business Practice Location Address
First Line : 5470 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4031
Country : US
Telephone Number : 773-287-2277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2007
Last Update Date : 07/08/2007

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