Provider Demographics
NPI:1548496219
Name:GEORGE J FUTRIS DDS LTD
Entity type:Organization
Organization Name:GEORGE J FUTRIS DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUTRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-699-1073
Mailing Address - Street 1:1600 W DEMPSTER ST STE 202
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1172
Mailing Address - Country:US
Mailing Address - Phone:847-699-1073
Mailing Address - Fax:847-699-1134
Practice Address - Street 1:1600 W DEMPSTER ST STE 202
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1172
Practice Address - Country:US
Practice Address - Phone:847-699-1073
Practice Address - Fax:847-699-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0144693140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric