Provider Demographics
NPI:1669089777
Name:SEBASTIAN PRZYBYLO, DMD, PLLC
Entity type:Organization
Organization Name:SEBASTIAN PRZYBYLO, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:PRZYBYLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:708-663-2621
Mailing Address - Street 1:921 S BISHOP ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3895
Mailing Address - Country:US
Mailing Address - Phone:708-663-2621
Mailing Address - Fax:
Practice Address - Street 1:350 S NORTHWEST HWY STE 116
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4262
Practice Address - Country:US
Practice Address - Phone:847-823-4161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty