Provider Demographics
NPI:1912111378
Name:ELIZABETH M SCHAIK PC
Entity Type:Organization
Organization Name:ELIZABETH M SCHAIK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST PRES OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHAIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-223-0110
Mailing Address - Street 1:100 N ATKINSON
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030
Mailing Address - Country:US
Mailing Address - Phone:847-223-0110
Mailing Address - Fax:847-223-4848
Practice Address - Street 1:100 N ATKINSON
Practice Address - Street 2:SUITE 104
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030
Practice Address - Country:US
Practice Address - Phone:847-223-0110
Practice Address - Fax:847-223-4848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01922731122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty