Teluk, Michael Paul

Teluk, Michael Paul is an sole proprietor health care provider with primary practice located at 95 W Grand Ave , Lake Villa IL 60046-8641. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Teluk, Michael Paul can be contacted via phone (847) 356-2336.

Contact Information

Primary practice address
95 W Grand Ave Lake Villa IL 60046-8641
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 019025969 Illinois

Profile Details

NPI number 1982759932
LBN Legal business name Teluk, Michael Paul
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982759932 NPPES
Illinois MEDICAID 9180851

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