Provider Demographics
NPI:1366712945
Name:RICHARD I. KAUFMAN & LOUIS R KAUFMAN DDS
Entity type:Organization
Organization Name:RICHARD I. KAUFMAN & LOUIS R KAUFMAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNERSHIP
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-643-6006
Mailing Address - Street 1:1525 E 53RD ST STE 734
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4575
Mailing Address - Country:US
Mailing Address - Phone:773-643-6006
Mailing Address - Fax:773-643-0278
Practice Address - Street 1:1525 E 53RD ST STE 734
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4575
Practice Address - Country:US
Practice Address - Phone:773-643-6006
Practice Address - Fax:773-643-0278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190239531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty