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NPI Code Detail

MEDICARE: DR. JEFFREY R WINTERICH DMD

MEDICARE: DR. JEFFREY R WINTERICH 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
1122300000XDentist019027762IL

General Provider Information

NPI Number : 1134374630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY R WINTERICH DMD
Provider Business Mailing Address
First Line : 3435 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3217
Country : US
Telephone Number : 773-588-8200
Fax Number : 773-588-8208
Provider Business Practice Location Address
First Line : 3435 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3217
Country : US
Telephone Number : 773-588-8200
Fax Number : 773-588-8208
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2008
Last Update Date : 12/02/2011

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