Organization
IRVING PARK PERIODONTICS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS FREDERIC SCHNEIDER JR. DDS (PRESIDENT)
(773) 794-1332
Entity
Organization
Contact information
Practice address
4949 W IRVING PARK RD, STE. D, CHICAGO, IL 60641-2655
(773) 794-1332
(773) 794-1032
Mailing address
4949 W IRVING PARK RD, STE. D, CHICAGO, IL 60641-2655
(773) 794-1332
(773) 794-1032
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
021001422
IL
Other
Enumeration date
01/27/2012
Last updated
01/27/2012
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