1881856011 NPI number — DR. MICHAEL STEWART LERMAN D.D.S.

Table of content: DR. MICHAEL STEWART LERMAN D.D.S. (NPI 1881856011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881856011 NPI number — DR. MICHAEL STEWART LERMAN D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LERMAN
Provider First Name:
MICHAEL
Provider Middle Name:
STEWART
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881856011
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1950 SHERIDAN RD
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
HIGHLAND PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60035-2548
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-433-7333
Provider Business Mailing Address Fax Number:
847-433-9107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1950 SHERIDAN RD
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
HIGHLAND PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60035-2548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-433-7333
Provider Business Practice Location Address Fax Number:
847-433-9107
Provider Enumeration Date:
06/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  019013837 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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