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Organization
EVASKUS AND HERZOG, LTD
Active
Organization
EVASKUS AND HERZOG, LTD
Active
Other names
Oral Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PIETRI (INSURANCE COORDINATOR)
(773) 761-7171
Entity
Organization
Contact information
Practice address
2440 W PETERSON AVE, CHICAGO, IL 60659-4113
(773) 761-7171
(773) 761-6714
Mailing address
2440 W PETERSON AVE, CHICAGO, IL 60659-4113
(773) 761-7171
(773) 761-6714
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
060003037
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
09/19/2006
Last updated
12/09/2019
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