Provider Demographics
NPI:1326258484
Name:WEBSTER DENTAL CARE OF LAKEVIEW, LTD
Entity Type:Organization
Organization Name:WEBSTER DENTAL CARE OF LAKEVIEW, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:REMPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-528-8900
Mailing Address - Street 1:6548 N NOKOMIS AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3026
Mailing Address - Country:US
Mailing Address - Phone:847-763-5890
Mailing Address - Fax:
Practice Address - Street 1:2829 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6932
Practice Address - Country:US
Practice Address - Phone:773-528-8900
Practice Address - Fax:773-528-0831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210016071223E0200X
IL0190156311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty