Individual
DR. BRIAN C. GNIADEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2031 E GRAND AVE STE 101, LINDENHURST, IL 60046-9094
(847) 265-9070
(847) 265-9279
Mailing address
2031 E GRAND AVE STE 101, LINDENHURST, IL 60046-9094
(847) 265-9070
(847) 265-9279
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-022558
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36-4247595
TAX ID
IL
01
—
784607
UCCI PROVIDER #
IL
Enumeration date
01/18/2007
Last updated
07/27/2020
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