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General NPI Number Information
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NPI Number | 1780888651
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Entity Type | Individual
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Provider Name | MICHAEL NICHOLAS KOROMPILAS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1310 SHERMER RD SUITE 50
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City | NORTHBROOK
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State | IL
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Zip | 60062-4579
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Country | US
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Telephone | 847-272-0049
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Fax | 847-272-6474
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Provider Business Mailing Address
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Address Line | 1310 SHERMER RD SUITE 50
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City | NORTHBROOK
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State | IL
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Zip | 60062-4579
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Country | US
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Telephone | 847-272-0049
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Fax | 847-272-6474
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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 |
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License Number State | IL
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