Provider Demographics
NPI:1538305610
Name:JEFFREY A. HALPERN, DDS, LTD
Entity Type:Organization
Organization Name:JEFFREY A. HALPERN, DDS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALPERN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-827-6300
Mailing Address - Street 1:701 LEE ST
Mailing Address - Street 2:SUITE 640
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4539
Mailing Address - Country:US
Mailing Address - Phone:847-827-6300
Mailing Address - Fax:847-827-6306
Practice Address - Street 1:701 LEE ST
Practice Address - Street 2:SUITE 640
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4539
Practice Address - Country:US
Practice Address - Phone:847-827-6300
Practice Address - Fax:847-827-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019022874(021001595)261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019022874Medicaid
ILU37686Medicare UPIN