Provider Demographics
NPI:1396820601
Name:PAUL M STEC DDS LTD
Entity Type:Organization
Organization Name:PAUL M STEC DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-747-1700
Mailing Address - Street 1:3700 W 203RD ST
Mailing Address - Street 2:STE 215
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1019
Mailing Address - Country:US
Mailing Address - Phone:708-747-1700
Mailing Address - Fax:708-747-3924
Practice Address - Street 1:3700 W 203RD ST
Practice Address - Street 2:STE 215
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1019
Practice Address - Country:US
Practice Address - Phone:708-747-1700
Practice Address - Fax:708-747-3924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212176Medicare ID - Type Unspecified