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General NPI Number Information
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NPI Number | 1760831465
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Entity Type | Individual
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Provider Name | MATTHEW JOSEPH ZIELINSKI D.D.S
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Gender | Male
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 05/28/2022
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Provider Practice Location Address
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Address Line | 10 W PHILLIP RD STE 128
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City | VERNON HILLS
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State | IL
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Zip | 60061-1796
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Country | US
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Telephone | 847-367-6410
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Fax |
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Provider Business Mailing Address
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Address Line | 10 W PHILLIP RD STE 128
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City | VERNON HILLS
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State | IL
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Zip | 60061-1796
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Country | US
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Telephone | 847-367-6410
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 018.001991
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.030875
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License Number State | IL
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