Individual
DR. FRED EUGENE BURKHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
6027 W ADDISON ST, CHICAGO, IL 60634-4210
(773) 736-2688
Mailing address
6027 W ADDISON ST, CHICAGO, IL 60634-4210
(773) 736-2688
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019011410
IL
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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