Organization
RICHARD J PASIEWICZ DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J PASIEWICZ DDS (OWNER)
(847) 721-9945
Entity
Organization
Contact information
Practice address
7600 W COLLEGE DR STE 17, PALOS HEIGHTS, IL 60463-1066
(708) 361-1770
Mailing address
1413 N LEAVITT ST, CHICAGO, IL 60622-1816
(847) 721-9945
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
021.002593
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019.028655
LICENSE NUMBER
IL
01
—
021.002593
LICENSE NUMBER
IL
01
—
1043506934
INDIVIDUAL NPI
—
Enumeration date
04/20/2018
Last updated
04/20/2018
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