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NPI Code Detail

MEDICARE: ARMITAGE ORAL SURGERY

MEDICARE: ARMITAGE ORAL SURGERY
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
11223S0112XOral and Maxillofacial Surgery (Dentist)IL

General Provider Information

NPI Number : 1760679294
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARMITAGE ORAL SURGERY
Provider Business Mailing Address
First Line : 2220 W ARMITAGE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-4461
Country : US
Telephone Number : 773-697-4188
Fax Number : 773-697-4189
Provider Business Practice Location Address
First Line : 2220 W ARMITAGE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-4461
Country : US
Telephone Number : 773-697-4188
Fax Number : 773-697-4189
Authorized Official
Title or Position : OWNER
Name : DR. FIRAS F. KATABI
Credential : D.D.S
Telephone Number : 773-697-4188
Provider Enumeration Date : 09/28/2007
Last Update Date : 09/28/2007

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Directions to “ARMITAGE ORAL SURGERY ” Practice Location

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