Provider Demographics
NPI:1003140187
Name:STEVEN KAHN D.D.S. P.C.
Entity Type:Organization
Organization Name:STEVEN KAHN D.D.S. P.C.
Other - Org Name:DR. STEVEN KAHN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-269-0100
Mailing Address - Street 1:25 EAST WASHINGTON ST.
Mailing Address - Street 2:SUITE 1823
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1833
Mailing Address - Country:US
Mailing Address - Phone:312-269-0100
Mailing Address - Fax:312-269-0004
Practice Address - Street 1:25 EAST WASHINGTON STREET
Practice Address - Street 2:SUITE 1823
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1833
Practice Address - Country:US
Practice Address - Phone:312-269-0100
Practice Address - Fax:312-269-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.01385122300000X
IL021.0009311223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37501Medicare UPIN
IL653570Medicare PIN