Provider Demographics
NPI:1265504757
Name:DRS. ZLOTKOWSKI & PAPANICOLAS, INC
Entity Type:Organization
Organization Name:DRS. ZLOTKOWSKI & PAPANICOLAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPANICOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-233-6800
Mailing Address - Street 1:3218 W 115TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60655-2805
Mailing Address - Country:US
Mailing Address - Phone:773-233-6800
Mailing Address - Fax:773-233-7221
Practice Address - Street 1:3218 W 115TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-2805
Practice Address - Country:US
Practice Address - Phone:773-233-6800
Practice Address - Fax:773-233-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty