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General NPI Number Information
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NPI Number | 1760679294
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Entity Type | Organization
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Legal Business Name | ARMITAGE ORAL SURGERY
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 2220 W ARMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-4461
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Country | US
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Telephone | 773-697-4188
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Fax | 773-697-4189
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Provider Business Mailing Address
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Address Line | 2220 W ARMITAGE AVE
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City | CHICAGO
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State | IL
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Zip | 60647-4461
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Country | US
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Telephone | 773-697-4188
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Fax | 773-697-4189
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Authorized Official
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Title or Position | OWNER
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Name | DR. FIRAS F. KATABI
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Credential | D.D.S
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Telephone | 773-697-4188
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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 |
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License Number State | IL
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