Individual
THOMAS EVAN BACKERIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 327-3041
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 327-3041
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1223S0112X
IL
Other
Enumeration date
03/05/2017
Last updated
03/05/2017
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