Jason P Theobald in Great Lakes - General Practice
Jason P Theobald - NPI 1285826420
Jason P Theobald is a General Practice in Great Lakes, Illinois. Jason P Theobald practices all healthcare services and medical treatments related to General Practice. The NPI Number for Jason P Theobald is 1285826420. The last update date is 2007-10-10.
Jason P Theobald's current location address is 3001 6th St Ste A, Great Lakes, Illinois. You can contact this provider via phone number 8476882100. The mailing address for Jason P Theobald is 3001 6th St Ste A, Great Lakes, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jason P Theobald |
|---|---|
| Address | 3001 6th St Ste A, Great Lakes, Illinois |
| Phone Number | 8476882100 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1285826420 |
|---|---|
| Provider Enumeration Date | 2007-08-13 |
| Last Updated Date | 2007-10-10 |
Provider Mailing Address Detail
| Address | 3001 6th St Ste A |
|---|---|
| City | Great Lakes |
| State | Illinois (IL) |
| Post Code | 60088 |
| Phone Number | 8476882100 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identification code assigned to Jason P Theobald by the Centers for Medicare & Medicaid Services?
The Jason P Theobald has been issued the NPI (National Provider Identifier) 1285826420, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Jason P Theobald?
The Jason P Theobald is physically situated at 3001 6Th St Ste A, in the city of Great Lakes, state of IL, with the postal code 60088.
What is the Jason P Theobald's area of specialization and corresponding taxonomy classification?
The Jason P Theobald's specialty field is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their specialties.
On what date did the Jason P Theobald receive the assignment of its 1285826420 from the Centers for Medicare & Medicaid Services?
The Jason P Theobald was issued its 1285826420 by the Centers for Medicare & Medicaid Services on 2007-08-13.
When was the information regarding Jason P Theobald, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Jason P Theobald, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-10-10.
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