MEDICARE: MR. STEFAN J PRESSLING DDS

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	190016906	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1508977646	OTHER	IL	TYPE 2 NPI

General Provider Information

NPI Number	:	1730427667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEFAN J PRESSLING DDS

Provider Business Mailing Address
First Line	:	3460 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1173
Country	:	US
Telephone Number	:	773-549-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3460 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1173
Country	:	US
Telephone Number	:	773-549-2800
Fax Number	:

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

Provider Enumeration Date	:	01/28/2013
Last Update Date	:	01/28/2013

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