Individual
DR. ELLIS J NEIBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 NORTH AVE, WAUKEGAN, IL 60085-2938
(847) 244-0292
Mailing address
1000 NORTH AVE, WAUKEGAN, IL 60085-2938
(847) 244-0292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19013414
IL
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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