Provider Demographics
NPI:1326232125
Name:TOLWIN, TERRENCE M
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:M
Last Name:TOLWIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N WABASH AVE
Mailing Address - Street 2:#2022
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2005
Mailing Address - Country:US
Mailing Address - Phone:312-726-9666
Mailing Address - Fax:312-726-7326
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:STE 2022
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2005
Practice Address - Country:US
Practice Address - Phone:312-726-9666
Practice Address - Fax:312-726-7326
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics