Organization
PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC
Active
Other names
Periodontal Medicine and Surgical Specialists, LTD
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE MANDELARIS DDS, MS (PRESIDENT)
(630) 627-3930
Entity
Organization
Contact information
Practice address
1009 W WEBSTER AVE, CHICAGO, IL 60614-3502
(630) 627-3930
Mailing address
1S224 SUMMIT AVE, SUITE 205, OAKBROOK TERRACE, IL 60181-3983
(630) 627-3930
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
021001938
IL
1223P0300X
Periodontics
021002676
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
021002351
IL
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
04/15/2016
Last updated
12/23/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us