MEDICARE: DR. JEFFREY ANTHONY SEREDYNSKI D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	019030278	IL

General Provider Information

NPI Number	:	1033593546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ANTHONY SEREDYNSKI D.M.D.

Provider Business Mailing Address
First Line	:	121 S WILKE RD STE 120
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1524
Country	:	US
Telephone Number	:	847-392-2141
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 S WILKE RD STE 120
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1524
Country	:	US
Telephone Number	:	847-392-2141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2015
Last Update Date	:	11/10/2021

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