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NPI Code Detail

MEDICARE: DR. CRAIG LEE SABIN D.D.S

MEDICARE: DR. CRAIG LEE SABIN 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 DentistryA15241IL

General Provider Information

NPI Number : 1730258567
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRAIG LEE SABIN D.D.S
Provider Business Mailing Address
First Line : 4401 W LAWRENCE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-2510
Country : US
Telephone Number : 773-725-6086
Fax Number : 773-725-4756
Provider Business Practice Location Address
First Line : 4401 W LAWRENCE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-2510
Country : US
Telephone Number : 773-725-6086
Fax Number : 773-725-4756
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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