Provider Demographics
NPI:1255595310
Name:DRS BOYER & SCHEIVE D D S P C
Entity type:Organization
Organization Name:DRS BOYER & SCHEIVE D D S P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-893-4530
Mailing Address - Street 1:183 S BLOOMINGDALE RD
Mailing Address - Street 2:STE. 205
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1466
Mailing Address - Country:US
Mailing Address - Phone:630-893-4530
Mailing Address - Fax:630-893-4584
Practice Address - Street 1:183 S BLOOMINGDALE RD
Practice Address - Street 2:STE. 205
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1466
Practice Address - Country:US
Practice Address - Phone:630-893-4530
Practice Address - Fax:630-893-4584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190159791223S0112X
IL0190151021223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT37930Medicare UPIN
ILT38790Medicare UPIN