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NPI Code Detail

MEDICARE: ALLISON K ALBERTS D.D.S.

MEDICARE: ALLISON K ALBERTS 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
1122300000XDentist019029564IL

General Provider Information

NPI Number : 1568896637
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON K ALBERTS D.D.S.
Provider Business Mailing Address
First Line : 3057 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623
Country : US
Telephone Number : 773-257-0200
Fax Number :
Provider Business Practice Location Address
First Line : 3057 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3548
Country : US
Telephone Number : 773-257-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2013
Last Update Date : 08/26/2013

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