MEDICARE: CHRIS KYROS, D.D.S., LTD.

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		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700056371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRIS KYROS, D.D.S., LTD.

Provider Business Mailing Address
First Line	:	8957 W GOLF RD
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-5812
Country	:	US
Telephone Number	:	847-827-9850
Fax Number	:

Provider Business Practice Location Address
First Line	:	8957 W GOLF RD
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-5812
Country	:	US
Telephone Number	:	847-827-9850
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHRIS KYROS
Credential	:	D.D.S.
Telephone Number	:	847-827-9850

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	03/10/2008

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