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General NPI Number Information
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NPI Number | 1285773945
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Entity Type | Organization
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Legal Business Name | SIMON AND SIMON, P.C.
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3800 N PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60641-3139
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Country | US
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Telephone | 773-663-3800
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Fax | 773-663-3146
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Provider Business Mailing Address
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Address Line | 3800 N PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60641-3139
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Country | US
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Telephone | 773-663-3800
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Fax | 773-663-3146
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM SIMON
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Credential | D.M.D.
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Telephone | 773-663-3800
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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 | 19018557
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License Number State | IL
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