MEDICARE: DR. JOSHUA ADAM RIES DMD

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	1223E0200X	Endodontics	021.002196	IL

General Provider Information

NPI Number	:	1073673323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA ADAM RIES DMD

Provider Business Mailing Address
First Line	:	2551 N CLARK ST STE 701
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1705
Country	:	US
Telephone Number	:	773-244-1933
Fax Number	:	773-244-2933

Provider Business Practice Location Address
First Line	:	845 N MICHIGAN AVE STE 921E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2213
Country	:	US
Telephone Number	:	312-751-0026
Fax Number	:	312-751-0241

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

Provider Enumeration Date	:	12/09/2006
Last Update Date	:	07/16/2015

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