MEDICARE: ELISABETA GABRIELA ALUAS 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	1223G0001X	General Practice Dentistry	019025705	IL

General Provider Information

NPI Number	:	1962617910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETA GABRIELA ALUAS DDS

Provider Business Mailing Address
First Line	:	6122 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-2314
Country	:	US
Telephone Number	:	773-739-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	6122 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-2314
Country	:	US
Telephone Number	:	773-739-2800
Fax Number	:

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

Provider Enumeration Date	:	05/13/2007
Last Update Date	:	07/08/2007

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