Jankowski, Walter J

Jankowski, Walter J is an individual health care provider with primary practice located at 5011 N. Illinois St. Ste 1, Fairview Heights IL 62208-1717. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Jankowski, Walter J can be contacted via phone (618) 222-1942.

Contact Information

Primary practice address
5011 N. Illinois St. Ste 1 Fairview Heights IL 62208-1717
Phone: (618) 222-1942
Fax: (618) 222-2819
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019024660 Illinois
Dental Providers / Dentist 122300000X 019024660 Illinois

Profile Details

NPI number 1700805512
LBN Legal business name Jankowski, Walter J
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Aug 6th, 2009 - about 17 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 1700805512 NPPES
Illinois Other 1318983 UNITED CONCORDIA PROVIDER

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