Provider Demographics
NPI:1831109081
Name:PARTNERS IN ORAL HEALTH-ORTHODONTIC
Entity Type:Organization
Organization Name:PARTNERS IN ORAL HEALTH-ORTHODONTIC
Other - Org Name:PARTNERS IN ORAL HEALTH ORTHODONTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:FEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-537-7698
Mailing Address - Street 1:195 ARLINGTON HTS RD
Mailing Address - Street 2:ST 150
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089
Mailing Address - Country:US
Mailing Address - Phone:847-537-7695
Mailing Address - Fax:847-537-6758
Practice Address - Street 1:195 ARLINGTON HTS RD
Practice Address - Street 2:ST 150
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089
Practice Address - Country:US
Practice Address - Phone:847-537-7695
Practice Address - Fax:847-537-6758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223S0112X
IL0210020131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty