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Organization
NORTHSHORE CENTER FOR SLEEP DENTISTRY, LTD
Active
Organization
NORTHSHORE CENTER FOR SLEEP DENTISTRY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL SANIUK D.D.S. (PRESIDENT)
(773) 509-0029
Entity
Organization
Contact information
Practice address
6314 N LINCOLN AVE, CHICAGO, IL 60659-1204
(773) 509-0029
(773) 509-0733
Mailing address
6314 N LINCOLN AVE, CHICAGO, IL 60659-1204
(773) 509-0029
(773) 509-0733
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019017944
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019017944
LICENSED DENTIST
IL
01
—
1073655213
PERSONAL NPI
IL
Enumeration date
11/05/2014
Last updated
02/10/2021
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