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General NPI Number Information
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NPI Number | 1093727570
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Entity Type | Individual
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Provider Name | DAVID DREYFUSS M.D,
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17850 KEDZIE AVE SUITE 2200
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City | HAZEL CREST
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State | IL
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Zip | 60429-2058
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Country | US
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Telephone | 708-799-9782
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Fax | 708-799-8175
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Provider Business Mailing Address
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Address Line | 17850 KEDZIE AVE SUITE 2200
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City | HAZEL CREST
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State | IL
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Zip | 60429-2058
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Country | US
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Telephone | 708-799-9782
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Fax | 708-799-8175
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 01039930A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State | IL
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