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NPI Code Detail

MEDICARE: SANEI CENTER PC

MEDICARE: SANEI CENTER PC
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
11223G0001XGeneral Practice Dentistry019.028529IL

General Provider Information

NPI Number : 1952659005
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANEI CENTER PC
Provider Business Mailing Address
First Line : 2604 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5235
Country : US
Telephone Number : 773-252-0033
Fax Number :
Provider Business Practice Location Address
First Line : 2604 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-5235
Country : US
Telephone Number : 773-252-0033
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BEHZAD SANEI
Credential : DMD
Telephone Number : 773-252-0033
Provider Enumeration Date : 08/21/2012
Last Update Date : 08/21/2012

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Directions to “SANEI CENTER PC ” Practice Location

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