MEDICARE: BILLINS SYSTEMS PLUS, INC.

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	122300000X	Dentist

General Provider Information

NPI Number	:	1417184490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BILLINS SYSTEMS PLUS, INC.

Provider Business Mailing Address
First Line	:	802 W DIVERSEY PKWY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1412
Country	:	US
Telephone Number	:	773-975-2000
Fax Number	:	773-528-4166

Provider Business Practice Location Address
First Line	:	802 W DIVERSEY PKWY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1412
Country	:	US
Telephone Number	:	773-975-2000
Fax Number	:	773-528-4166

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. PAULINE SENNO
Credential	:
Telephone Number	:	773-508-9800

Provider Enumeration Date	:	06/17/2009
Last Update Date	:	06/17/2009

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