MEDICARE: SJ TERMINI, DDS PC

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	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1093117921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SJ TERMINI, DDS PC

Provider Business Mailing Address
First Line	:	1074 W TAYLOR ST # 207
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-4336
Country	:	US
Telephone Number	:	312-209-1770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1074 W TAYLOR ST # 207
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-4336
Country	:	US
Telephone Number	:	312-209-1770
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SALVATORE JOHN TERMINI
Credential	:	DDS
Telephone Number	:	312-209-1770

Provider Enumeration Date	:	09/23/2014
Last Update Date	:	09/23/2014

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