Herzog, Steven

Herzog, Steven is an individual health care provider with primary practice located at 2440 W Peterson Ave , Chicago IL 60659-4113. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Herzog, Steven can be contacted via phone (773) 761-7171.

Contact Information

Primary practice address
2440 W Peterson Ave Chicago IL 60659-4113
Phone: (773) 761-7171
Fax: (773) 761-6714
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 019-016111 Illinois
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 019-016111 Illinois

Profile Details

NPI number 1306063631
LBN Legal business name Herzog, Steven
Credentials D.D.S., M.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2007
Last updated Dec 16th, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1306063631 NPPES
Illinois MEDICAID 019016111

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