MEDICARE: DR. STEVEN PATRICK GEIERMANN D.D.S.

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	1223D0001X	Public Health Dentistry	2901013456	MI

General Provider Information

NPI Number	:	1114920964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN PATRICK GEIERMANN D.D.S.

Provider Business Mailing Address
First Line	:	5218 N WINTHROP AVE
Second Line	:	# 3N
City	:	CHICAGO
State	:	IL
Zip	:	60640-2306
Country	:	US
Telephone Number	:	773-271-5871
Fax Number	:	312-886-3770

Provider Business Practice Location Address
First Line	:	5218 N WINTHROP AVE
Second Line	:	# 3N
City	:	CHICAGO
State	:	IL
Zip	:	60640-2306
Country	:	US
Telephone Number	:	773-271-5871
Fax Number	:	312-886-3770

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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