MEDICARE: DR. MICHAEL WALTER NABOROWSKI 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	174400000X	Specialist		IL

General Provider Information

NPI Number	:	1992922231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL WALTER NABOROWSKI D.D.S.

Provider Business Mailing Address
First Line	:	1201 W ARMY TRAIL BLVD
Second Line	:
City	:	ADDISON
State	:	IL
Zip	:	60101-3152
Country	:	US
Telephone Number	:	630-543-5051
Fax Number	:	630-543-2450

Provider Business Practice Location Address
First Line	:	1201 W ARMY TRAIL BLVD
Second Line	:
City	:	ADDISON
State	:	IL
Zip	:	60101-3152
Country	:	US
Telephone Number	:	630-543-5051
Fax Number	:	630-543-2450

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/08/2007

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