MEDICARE: DR. MEAGAN KARA VOUZIERS 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
1	122300000X	Dentist	019029116	IL

General Provider Information

NPI Number	:	1568715472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEAGAN KARA VOUZIERS D.D.S.

Provider Business Mailing Address
First Line	:	807 DAVIS ST
Second Line	:	UNIT 708
City	:	EVANSTON
State	:	IL
Zip	:	60201-4471
Country	:	US
Telephone Number	:	231-392-6309
Fax Number	:

Provider Business Practice Location Address
First Line	:	5643 N FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-4816
Country	:	US
Telephone Number	:	271-773-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2012
Last Update Date	:	10/17/2012

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