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General NPI Number Information
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NPI Number | 1437375045
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Entity Type | Organization
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Legal Business Name | HAROLD J. BIRKY DDS LTD.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 3115 LEWIS AVE
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City | ZION
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State | IL
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Zip | 60099-3099
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Country | US
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Telephone | 847-746-8622
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Fax | 847-746-8215
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Provider Business Mailing Address
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Address Line | 3115 LEWIS AVE
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City | ZION
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State | IL
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Zip | 60099-3099
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Country | US
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Telephone | 847-746-8622
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Fax | 847-746-8215
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HAROLD JOHN BIRKY
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Credential |
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Telephone | 847-746-8622
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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 | 060002045
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License Number State | IL
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