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General NPI Number Information
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NPI Number | 1609907013
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Entity Type | Individual
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Provider Name | LILLIAN OBUCINA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 104 S MICHIGAN AVE 727
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City | CHICAGO
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State | IL
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Zip | 60603-5902
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Country | US
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Telephone | 312-909-2839
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Fax | 888-676-3674
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Provider Business Mailing Address
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Address Line | 253 E DELAWARE PL 20F
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City | CHICAGO
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State | IL
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Zip | 60611-1758
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Country | US
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Telephone | 312-909-2839
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Fax | 888-676-3674
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 019021263
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License Number State | IL
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