Provider Demographics
NPI:1851983548
Name:ESD LOMBARD, PC
Entity Type:Organization
Organization Name:ESD LOMBARD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:SZATKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-394-9040
Mailing Address - Street 1:76 STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2201
Mailing Address - Country:US
Mailing Address - Phone:630-394-9040
Mailing Address - Fax:
Practice Address - Street 1:660 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4776
Practice Address - Country:US
Practice Address - Phone:630-627-7651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental