Formeller, John M

Formeller, John M is an sole proprietor health care provider with primary practice located at 1220 Meadow Rd Suite 204, Northbrook IL 60062-3698. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Formeller, John M can be contacted via phone (847) 272-9666.

Contact Information

Primary practice address
1220 Meadow Rd Suite 204 Northbrook IL 60062-3698
Phone: (847) 272-9666
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019021481 Illinois

Profile Details

NPI number 1952455107
LBN Legal business name Formeller, John M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2007
Last updated Dec 6th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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