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NPI Code Detail

MEDICARE: JAY SWEIS DDS PC

MEDICARE: JAY SWEIS 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
1122300000XDentist019028603IL

General Provider Information

NPI Number : 1386077741
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAY SWEIS DDS PC
Provider Business Mailing Address
First Line : 2715 N CENTRAL AVE
Second Line : STE 2A
City : CHICAGO
State : IL
Zip : 60639-1351
Country : US
Telephone Number : 773-844-5283
Fax Number :
Provider Business Practice Location Address
First Line : 2937 ILLINOIS 178
Second Line :
City : NORTH UTICA
State : IL
Zip : 61373
Country : US
Telephone Number : 773-844-5283
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. JUBRAIL SWEIS
Credential : D.D.S.
Telephone Number : 773-844-5283
Provider Enumeration Date : 08/20/2013
Last Update Date : 08/20/2013

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