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General NPI Number Information
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NPI Number | 1912079690
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Entity Type | Organization
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Legal Business Name | DR. LOUIS L. GREENBERG LTD.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 7114 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60645-3418
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Country | US
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Telephone | 773-465-1810
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Fax | 773-465-1194
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Provider Business Mailing Address
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Address Line | 7114 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60645-3418
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Country | US
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Telephone | 773-465-1810
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Fax | 773-465-1194
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL BAER KIRSHENBAUM
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Credential | D.D.S.
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Telephone | 773-465-1810
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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 | 019-014090
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License Number State | IL
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