Healthcare Provider Details

I. General information

NPI: 1194087189
Provider Name (Legal Business Name): GEORGE F. WARGA DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2012
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 CHESTNUT ST
WINNETKA IL
60093-2438
US

IV. Provider business mailing address

485 CHESTNUT ST
WINNETKA IL
60093-2438
US

V. Phone/Fax

Practice location:
  • Phone: 847-441-6510
  • Fax: 847-441-0510
Mailing address:
  • Phone: 847-441-6510
  • Fax: 847-441-0510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number019019933
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019019933
License Number StateIL

VIII. Authorized Official

Name: DR. GEORGE F WARGA
Title or Position: GENERAL DENTISTRY
Credential: DDS
Phone: 847-441-6510