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General NPI Number Information
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NPI Number | 1104285972
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Entity Type | Organization
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Legal Business Name | RICHARD F. CALLAHAN, LTD.
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 02/22/2016
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Provider Practice Location Address
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Address Line | 10 BRIARCLIFF PROFESSIONAL CENTER
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City | BOURBONNAIS
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State | IL
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Zip | 60914-1775
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Country | US
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Telephone | 815-939-2585
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Fax | 815-939-7857
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Provider Business Mailing Address
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Address Line | 10 BRIARCLIFF PROFESSIONAL CENTER
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City | BOURBONNAIS
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State | IL
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Zip | 60914
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Country | US
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Telephone | 815-939-2585
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Fax | 815-939-7857
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. RICHARD F. CALLAHAN
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Credential |
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Telephone | 815-939-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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