MEDICARE: DR. WILLIAM JAMES MCSWEENEY JR. 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
1	122300000X	Dentist	19A14109	IL

General Provider Information

NPI Number	:	1912276940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JAMES MCSWEENEY JR. D,D,S,

Provider Business Mailing Address
First Line	:	70 TURNER AVENUE
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3955
Country	:	US
Telephone Number	:	847-437-3250
Fax Number	:	847-437-3251

Provider Business Practice Location Address
First Line	:	70 TURNER AVENUE
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3955
Country	:	US
Telephone Number	:	847-437-3250
Fax Number	:	847-437-3251

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

Provider Enumeration Date	:	12/20/2011
Last Update Date	:	12/20/2011

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