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General NPI Number Information
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NPI Number | 1174827042
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Entity Type | Organization
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Legal Business Name | DR. STACI SIKORA AND ASSOCIATES
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Dates
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Enumeration Date | 01/06/2011
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 111 W JACKSON BLVD STE 1410
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City | CHICAGO
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State | IL
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Zip | 60604-3867
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Country | US
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Telephone | 312-939-2400
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Fax | 312-987-1535
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Provider Business Mailing Address
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Address Line | 111 W JACKSON BLVD STE 1410
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City | CHICAGO
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State | IL
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Zip | 60604-3867
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Country | US
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Telephone | 312-939-2400
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Fax | 312-987-1535
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | STACI CARYN SIKORA
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Credential | DDS
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Telephone | 313-939-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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