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NPI Code Detail

MEDICARE: DR. EUGENE Z WALCHIRK D.D.S.

MEDICARE: DR. EUGENE Z WALCHIRK 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
11223E0200XEndodonticsIL

General Provider Information

NPI Number : 1215131131
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EUGENE Z WALCHIRK D.D.S.
Provider Business Mailing Address
First Line : 4235 W 95TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2623
Country : US
Telephone Number : 708-499-2424
Fax Number :
Provider Business Practice Location Address
First Line : 2829 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-6932
Country : US
Telephone Number : 773-528-8900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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