Provider Demographics
NPI:1811233695
Name:DR. KAREN FIELDS INC
Entity type:Organization
Organization Name:DR. KAREN FIELDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-647-1830
Mailing Address - Street 1:4201 N MOBILE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-1549
Mailing Address - Country:US
Mailing Address - Phone:313-647-1830
Mailing Address - Fax:
Practice Address - Street 1:7610 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-2295
Practice Address - Country:US
Practice Address - Phone:313-647-1830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-22
Last Update Date:2012-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0277791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty