Provider Demographics
NPI:1538379490
Name:CHARLES E BALEK DDS PC
Entity type:Organization
Organization Name:CHARLES E BALEK DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BALEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-406-6140
Mailing Address - Street 1:1001 E WILSON ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-2208
Mailing Address - Country:US
Mailing Address - Phone:630-406-6140
Mailing Address - Fax:
Practice Address - Street 1:1001 E WILSON ST
Practice Address - Street 2:SUITE 120
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2208
Practice Address - Country:US
Practice Address - Phone:630-406-6140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty