Provider Demographics
NPI:1417664020
Name:LITTLE CHOMPERS PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:LITTLE CHOMPERS PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:RABINOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-962-6321
Mailing Address - Street 1:5305 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2113
Mailing Address - Country:US
Mailing Address - Phone:312-471-6430
Mailing Address - Fax:312-471-6431
Practice Address - Street 1:5305 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2113
Practice Address - Country:US
Practice Address - Phone:312-471-6430
Practice Address - Fax:312-471-6431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty