Provider Demographics
NPI:1275709990
Name:ELIZABETH PAJAK DDS, LTD
Entity Type:Organization
Organization Name:ELIZABETH PAJAK DDS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAJAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-458-4576
Mailing Address - Street 1:120 EASTGATE CT
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-3001
Mailing Address - Country:US
Mailing Address - Phone:847-458-4576
Mailing Address - Fax:
Practice Address - Street 1:120 EASTGATE CT
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-3001
Practice Address - Country:US
Practice Address - Phone:847-458-4576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1005636Medicaid