Provider Demographics
NPI:1467581777
Name:FURMANEK, SYLVESTER WALTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SYLVESTER
Middle Name:WALTER
Last Name:FURMANEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 N BROADWAY ST
Mailing Address - Street 2:31
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1450
Mailing Address - Country:US
Mailing Address - Phone:773-764-3682
Mailing Address - Fax:847-255-8318
Practice Address - Street 1:6355 N BROADWAY ST
Practice Address - Street 2:31
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1450
Practice Address - Country:US
Practice Address - Phone:773-764-3682
Practice Address - Fax:847-255-8318
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A12478122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist