Healthcare Provider Details

I. General information

NPI: 1588764450
Provider Name (Legal Business Name): DANIEL ARTHUR GREENBERG DDS PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 E WASHINGTON SUITE 2033
CHICAGO IL
60602
US

IV. Provider business mailing address

25 E WASHINGTON SUITE 2033
CHICAGO IL
60602
US

V. Phone/Fax

Practice location:
  • Phone: 312-782-4068
  • Fax: 312-782-6509
Mailing address:
  • Phone: 312-782-4068
  • Fax: 312-782-6509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: