Organization
CHARLES LOCKHART DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT D CRAIG CEO (CEO)
(312) 676-9893
Entity
Organization
Contact information
Practice address
150 E HURON ST, SUITE 1103, CHICAGO, IL 60611-2999
(312) 676-9893
(815) 744-7059
Mailing address
4748 N MILWAUKEE AVE STE 1, CHICAGO, IL 60630-3617
(773) 685-9339
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019014618
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457579682
TYPE 1 INDIVIDUAL NPI
—
Enumeration date
04/22/2011
Last updated
02/08/2023
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