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General NPI Number Information
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NPI Number | 1548435654
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Entity Type | Organization
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Legal Business Name | JOHN J. DZAKOVICH DDS LTD.
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 1608 N ARLINGTON HEIGHTS RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-3908
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Country | US
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Telephone | 847-255-4889
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Fax | 847-255-4834
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Provider Business Mailing Address
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Address Line | 1608 N ARLINGTON HEIGHTS RD
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-3908
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Country | US
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Telephone | 847-255-4889
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Fax | 847-255-4834
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KATHY BLAIR
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Credential |
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Telephone | 847-255-4889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 019-0016695
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License Number State | IL
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