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NPI Code Detail

MEDICARE: DR. MICHAEL JOHN CHUTICH DDS

MEDICARE: DR. MICHAEL JOHN CHUTICH 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
11223E0200XEndodontics019-017352IL

General Provider Information

NPI Number : 1902882798
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOHN CHUTICH DDS
Provider Business Mailing Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number : 630-743-4537
Provider Business Practice Location Address
First Line : 3450 LACEY RD
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5430
Country : US
Telephone Number : 630-743-4500
Fax Number : 630-743-4500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 05/16/2018

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Directions to “ DR. MICHAEL JOHN CHUTICH DDS” Practice Location

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