| Drs. Slaby, Adams And Tietjens, Ltd. | |
|
750 Almar Pkwy Suite 102 Bourbonnais IL 60914-2315 | |
| (815) 939-7136 | |
| (815) 939-9820 |
| Full Name | Drs. Slaby, Adams And Tietjens, Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 750 Almar Pkwy, Bourbonnais, Illinois |
| Authorized Official Name and Position | James Matthew Adams (PRESIDENT) |
| Authorized Official Contact | 8159397136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Drs. Slaby, Adams And Tietjens, Ltd. 750 Almar Pkwy Suite 102 Bourbonnais IL 60914-2315 Ph: (815) 939-7136 | Drs. Slaby, Adams And Tietjens, Ltd. 750 Almar Pkwy Suite 102 Bourbonnais IL 60914-2315 Ph: (815) 939-7136 |
| NPI Number | 1891843637 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 03/31/2009 |
| Medicare PECOS PAC ID | 4587763750 |
|---|---|
| Medicare Enrollment ID | O20070628000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891843637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 060002115 (Illinois) | Primary |
| Provider Name | Kiiri T Tietjens |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1659435253 PECOS PAC ID: 2567561731 Enrollment ID: I20070629000122 |
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