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Provider Information for 1144583550

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DR. ATTA BADER DMD

Gender: MALE

Individual NPI: 1144583550

Calendar   Last Updated:  2012-06-20
  Certification Date: 

Details

Name Value
NPI 1144583550
Enumeration Date 2012-06-20
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 430 W ERIE ST
CHICAGO, IL 60654
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 430 W ERIE ST
CHICAGO, IL 60654
United States

Phone: 954-993-9345 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist IL 019.029039