Provider Demographics
NPI:1558704577
Name:JAY SWEIS D.D.S P.C
Entity Type:Organization
Organization Name:JAY SWEIS D.D.S P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUBRAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-308-5542
Mailing Address - Street 1:727 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-7054
Mailing Address - Country:US
Mailing Address - Phone:773-308-5542
Mailing Address - Fax:
Practice Address - Street 1:2715 N CENTRAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1351
Practice Address - Country:US
Practice Address - Phone:773-308-5542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty