Healthcare Provider Details

I. General information

NPI: 1740351949
Provider Name (Legal Business Name): GREGORY MICHAEL KARR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 SUMMIT ST SUITE 105
ELGIN IL
60120-3861
US

IV. Provider business mailing address

431 SUMMIT ST SUITE 105
ELGIN IL
60120-3861
US

V. Phone/Fax

Practice location:
  • Phone: 847-742-6717
  • Fax: 847-742-3951
Mailing address:
  • Phone: 847-742-6717
  • Fax: 847-742-3951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number01919004
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: