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NPI Code Detail

MEDICARE: DR. LOUIS A WHITESMAN DDS MS

MEDICARE: DR. LOUIS A WHITESMAN DDS MS
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
1122300000XDentist019026746IL

General Provider Information

NPI Number : 1861650152
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUIS A WHITESMAN DDS MS
Provider Business Mailing Address
First Line : 1 W SUPERIOR ST
Second Line : UNIT 2607
City : CHICAGO
State : IL
Zip : 60654-8803
Country : US
Telephone Number : 734-709-1363
Fax Number :
Provider Business Practice Location Address
First Line : 6020 W DIVERSEY AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-1108
Country : US
Telephone Number : 773-237-0707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2008
Last Update Date : 04/11/2013

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