Provider Demographics
NPI:1942568779
Name:MOPPER, HARTLIEB & ASSOCIATES LTD
Entity Type:Organization
Organization Name:MOPPER, HARTLIEB & ASSOCIATES LTD
Other - Org Name:CHICAGO BEAUTIFUL SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTLIEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-729-6080
Mailing Address - Street 1:2601 COMPASS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8077
Mailing Address - Country:US
Mailing Address - Phone:847-729-6080
Mailing Address - Fax:847-729-7809
Practice Address - Street 1:2601 COMPASS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8077
Practice Address - Country:US
Practice Address - Phone:847-729-6080
Practice Address - Fax:847-729-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0600104421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty