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NPI Code Detail

MEDICARE: DR. STEPHANIE MICHELLE WARD D.D.S.

MEDICARE: DR. STEPHANIE MICHELLE WARD 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
11223G0001XGeneral Practice Dentistry019025760IL
21223G0001XGeneral Practice Dentistry319014416IL
31223G0001XGeneral Practice DentistryBW8041939IL

General Provider Information

NPI Number : 1417000274
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE MICHELLE WARD D.D.S.
Provider Business Mailing Address
First Line : 2345 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3811
Country : US
Telephone Number : 773-579-0500
Fax Number : 773-579-0335
Provider Business Practice Location Address
First Line : 2345 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60608-3811
Country : US
Telephone Number : 773-579-0500
Fax Number : 773-579-0335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 07/08/2007

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