Andrew I Radovan in Great Lakes - Oral And Maxillofacial Surgery
Andrew I Radovan - NPI 1548226111
Andrew I Radovan is a Oral And Maxillofacial Surgery in Great Lakes, Illinois. Andrew I Radovan practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Andrew I Radovan is 1548226111. The last update date is 2007-10-30.
Andrew I Radovan's current location address is 3001 6th St Ste A, Great Lakes, Illinois. You can contact this provider via phone number 8476882100 and fax number 8476885995. The mailing address for Andrew I Radovan is 3001 6th St Ste A, Great Lakes, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Andrew I Radovan |
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Address | 3001 6th St Ste A, Great Lakes, Illinois |
Phone Number | 8476882100 |
Fax Number | 8476885995 |
Sole Proprietor | N |
Credentials | DDS |
NPI Number Detail
NPI Number | 1548226111 |
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Provider Enumeration Date | 2006-04-24 |
Last Updated Date | 2007-10-30 |
Provider Mailing Address Detail
Address | 3001 6th St Ste A |
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City | Great Lakes |
State | Illinois (IL) |
Post Code | 600882833 |
Phone Number | 8476882100 |
Fax Number | 8476885995 |
Provider's Primary Taxonomy Detail
Speciality | Oral And Maxillofacial Surgery |
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Taxonomy | 1223S0112X |
Licence No | 40488 |
Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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What is the unique identifier code issued to Andrew I Radovan by the Centers for Medicare & Medicaid Services (CMS)?
The Andrew I Radovan has been assigned the NPI (National Provider Identifier) 1548226111. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Andrew I Radovan located?
The Andrew I Radovan is located at 3001 6Th St Ste A, Great Lakes, IL 600882833.
What is Andrew I Radovan's specialized field of practice, and what is the corresponding taxonomy classification code?
The Andrew I Radovan's area of specialization is Oral And Maxillofacial Surgery, and the corresponding taxonomy code that categorizes this field of practice is 1223S0112X.
When did Andrew I Radovan receive its 1548226111 assignment?
The Andrew I Radovan was assigned its 1548226111 on 2006-04-24, which is the date when this unique identifier was issued to the organization.
When was the Andrew I Radovan's information last updated?
The Andrew I Radovan's information was last updated on 2007-10-30.
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