Provider Demographics
NPI:1578642369
Name:DAVID B. SCHWARTZ DDS LTD
Entity Type:Organization
Organization Name:DAVID B. SCHWARTZ DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ANDREW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-677-2808
Mailing Address - Street 1:9933 LAWLER AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3773
Mailing Address - Country:US
Mailing Address - Phone:847-677-2808
Mailing Address - Fax:
Practice Address - Street 1:9933 LAWLER AVE STE 340
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3773
Practice Address - Country:US
Practice Address - Phone:847-677-2808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190211561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31888OtherBLUE CROSS BLUE SHIELD
IL31888OtherBLUE CROSS BLUE SHIELD