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Provider Information for 1326450966



DR. ROBERT E PLACZEK

Gender: MALE

Individual NPI: 1326450966

Calendar Last Updated: 2014-06-02

Details

Name Value
NPI 1326450966
Enumeration Date 2014-06-02
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 5650 W. LAWRENCE AVE.
CHICAGO, IL 60630
United States

Phone: 773-427-1310 | Fax:
View Map External Link
Primary Practice Address 5650 W. LAWRENCE AVE.
CHICAGO, IL 60630
United States

Phone: 773-427-1310 | Fax:
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist IL 019.020384
Other Identifiers
Issuer State Number