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General NPI Number Information
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NPI Number | 1225711864
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Entity Type | Organization
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Legal Business Name | SECOND CITY ORTHODONTICS, P.C.
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 111 N WABASH AVE STE 810
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City | CHICAGO
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State | IL
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Zip | 60602-1912
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Country | US
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Telephone | 312-551-0500
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Fax | 312-372-0165
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Provider Business Mailing Address
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Address Line | 1665 DUFFY LN
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City | BANNOCKBURN
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State | IL
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Zip | 60015-1509
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Country | US
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Telephone | 847-347-7874
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. FRANK L KARKAZIS
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Credential | D.D.S.
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Telephone | 847-347-7874
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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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