Organization
WHICHDR ENTERPRISES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY S FLAGG DDS, MD (PRESIDENT)
(708) 922-1108
Entity
Organization
Contact information
Practice address
1820 RIDGE RD STE 301, HOMEWOOD, IL 60430-1759
(708) 922-1108
(708) 922-1236
Mailing address
18600 GOLF LN, HAZEL CREST, IL 60429
(708) 922-1108
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036092720
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21623278
BCBS
IL
Enumeration date
12/01/2006
Last updated
04/13/2009
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