Provider Demographics
NPI:1467607556
Name:ORA STUDIOS
Entity Type:Organization
Organization Name:ORA STUDIOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DJUKIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-384-4031
Mailing Address - Street 1:1827 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-1601
Mailing Address - Country:US
Mailing Address - Phone:312-328-9000
Mailing Address - Fax:312-328-9009
Practice Address - Street 1:1827 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-1601
Practice Address - Country:US
Practice Address - Phone:312-328-9000
Practice Address - Fax:312-328-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190243151223G0001X
IL0210020471223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty