Provider Demographics
NPI:1982804654
Name:WEBSTER DENTAL CARE NORTH SUBURBAN LTD
Entity Type:Organization
Organization Name:WEBSTER DENTAL CARE NORTH SUBURBAN LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:REMPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-673-7118
Mailing Address - Street 1:4833 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1357
Mailing Address - Country:US
Mailing Address - Phone:847-673-7118
Mailing Address - Fax:847-673-4709
Practice Address - Street 1:4833 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1357
Practice Address - Country:US
Practice Address - Phone:847-673-7118
Practice Address - Fax:847-673-4709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X, 1223G0001X, 1223G0001X, 1223G0001X, 1223G0001X, 1223G0001X, 1223G0001X, 1223P0221X, 1223P0221X, 1223P0300X, 1223S0112X, 1223S0112X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty