Provider Demographics
NPI:1437334307
Name:BIRG, ILANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ILANA
Middle Name:
Last Name:BIRG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2718
Mailing Address - Country:US
Mailing Address - Phone:847-446-7200
Mailing Address - Fax:847-446-7292
Practice Address - Street 1:281 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-2718
Practice Address - Country:US
Practice Address - Phone:847-446-7200
Practice Address - Fax:847-446-7292
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-023406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist