Provider Demographics
NPI:1235383076
Name:DR. WILLIAM J MCSWEENEY
Entity Type:Organization
Organization Name:DR. WILLIAM J MCSWEENEY
Other - Org Name:DR. WILLIAM J MCSWENNEY
Other - Org Type:Other Name
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCSWEENEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-437-3250
Mailing Address - Street 1:70 TURNER AVE
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3955
Mailing Address - Country:US
Mailing Address - Phone:847-437-3250
Mailing Address - Fax:847-437-3251
Practice Address - Street 1:70 TURNER AVENUE
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:IL
Practice Address - Zip Code:60007
Practice Address - Country:US
Practice Address - Phone:847-437-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. WILLIAM J MCSWEENEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-06
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A141091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty