Provider Demographics
NPI:1801556493
Name:JEFFREY PERMAN, D.D.S, PLLC
Entity type:Organization
Organization Name:JEFFREY PERMAN, D.D.S, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-465-8100
Mailing Address - Street 1:2845 W TOUHY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-2901
Mailing Address - Country:US
Mailing Address - Phone:773-465-8100
Mailing Address - Fax:
Practice Address - Street 1:2845 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-2901
Practice Address - Country:US
Practice Address - Phone:773-465-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental