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General NPI Number Information
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NPI Number | 1467607556
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Entity Type | Organization
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Legal Business Name | ORA STUDIOS
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 1827 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-1601
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Country | US
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Telephone | 312-328-9000
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Fax | 312-328-9009
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Provider Business Mailing Address
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Address Line | 1827 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-1601
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Country | US
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Telephone | 312-328-9000
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Fax | 312-328-9009
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | SUZANNA DJUKIC
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Credential |
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Telephone | 219-384-4031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 021002047
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019024315
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License Number State | IL
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