Provider Demographics
NPI:1457307910
Name:MAHARUKH E KRAVICH DDS LTD
Entity Type:Organization
Organization Name:MAHARUKH E KRAVICH DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHARUKH
Authorized Official - Middle Name:E
Authorized Official - Last Name:KRAVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-984-0032
Mailing Address - Street 1:30 N MICHIGAN AVE
Mailing Address - Street 2:STE. 1821
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3402
Mailing Address - Country:US
Mailing Address - Phone:312-984-0032
Mailing Address - Fax:312-416-0309
Practice Address - Street 1:30 N MICHIGAN AVE
Practice Address - Street 2:STE. 1821
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3402
Practice Address - Country:US
Practice Address - Phone:312-984-0032
Practice Address - Fax:312-419-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty