| J.v. Discipio, D.d.s. & Assoc., Ltd. | |
|
6737 Stanley Ave Berwyn IL 60402-3129 | |
| (708) 749-0133 | |
| (708) 749-7778 |
| Full Name | J.v. Discipio, D.d.s. & Assoc., Ltd. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6737 Stanley Ave, Berwyn, Illinois |
| Authorized Official Name and Position | James Lawrence Discipio (PRESIDENT-OWNER) |
| Authorized Official Contact | 7087490133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J.v. Discipio, D.d.s. & Assoc., Ltd. 6737 Stanley Ave Berwyn IL 60402-3129 Ph: (708) 749-0133 | J.v. Discipio, D.d.s. & Assoc., Ltd. 6737 Stanley Ave Berwyn IL 60402-3129 Ph: (708) 749-0133 |
| NPI Number | 1265508949 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265508949 | NPI | - | NPPES |
| $$$$$$$$$ | Other | IL | SOCIAL SECURITY NUMBER |
| $$$$$$$$$ | Other | IL | SOCIAL SECURITY NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19A19017 (Illinois) | Secondary |
| 1223G0001X | Dentist - General Practice | 19A-10123 (Illinois) | Primary |
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