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Organization
SJNOMOS
Active
Organization
SJNOMOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE JAMES KLERONOMOS DDS (PRESIDENT)
(773) 430-9216
Entity
Organization
Contact information
Practice address
8301 S BRANDON AVE, CHICAGO, IL 60617-2656
(773) 375-6199
Mailing address
8000 KILPATRICK AVE, SKOKIE, IL 60076-3013
(773) 430-9216
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019657
IL
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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