MEDICARE: DR. MARIA SINIS CONTOS D.M.D.

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	019028502	IL
2	122300000X	Dentist	S520540826110	FL

General Provider Information

NPI Number	:	1992014716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA SINIS CONTOS D.M.D.

Provider Business Mailing Address
First Line	:	6428 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-5209
Country	:	US
Telephone Number	:	773-973-0531
Fax Number	:	773-262-9850

Provider Business Practice Location Address
First Line	:	6428 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-5209
Country	:	US
Telephone Number	:	773-973-0531
Fax Number	:	773-262-9850

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

Provider Enumeration Date	:	09/28/2010
Last Update Date	:	06/03/2016

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