Provider Demographics
NPI:1437390689
Name:CYNTHIA SATKO DDS MS PC
Entity Type:Organization
Organization Name:CYNTHIA SATKO DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SATKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS PC
Authorized Official - Phone:708-246-6400
Mailing Address - Street 1:800 HILLGROVE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1490
Mailing Address - Country:US
Mailing Address - Phone:708-246-6400
Mailing Address - Fax:708-246-4920
Practice Address - Street 1:800 HILLGROVE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1490
Practice Address - Country:US
Practice Address - Phone:708-246-6400
Practice Address - Fax:708-246-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019018221261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK07744Medicare PIN