Organization
DRS COSTIS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES A COSTIS (DENTIST)
(773) 631-5693
Entity
Organization
Contact information
Practice address
5456 N MILWAUKEE AVE, CHICAGO, IL 60630-1225
(773) 631-5693
(773) 631-0058
Mailing address
5456 N MILWAUKEE AVE, CHICAGO, IL 60630-1225
(773) 631-5693
(773) 631-0058
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-022-163
IL
Other
Enumeration date
08/29/2008
Last updated
10/15/2020
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