Provider Demographics
NPI:1134475767
Name:DR CHAIKEN & ASSOC. DENTIST, LTD
Entity type:Organization
Organization Name:DR CHAIKEN & ASSOC. DENTIST, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:I
Authorized Official - Last Name:CHAIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-862-2266
Mailing Address - Street 1:500 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-5837
Mailing Address - Country:US
Mailing Address - Phone:708-862-2266
Mailing Address - Fax:
Practice Address - Street 1:500 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5837
Practice Address - Country:US
Practice Address - Phone:708-862-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty