Provider Demographics
NPI:1861727232
Name:NANCY A POZNICK, DDS, LLC
Entity type:Organization
Organization Name:NANCY A POZNICK, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOROTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-742-2508
Mailing Address - Street 1:165 N CANAL ST
Mailing Address - Street 2:#910
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1549
Mailing Address - Country:US
Mailing Address - Phone:219-742-2508
Mailing Address - Fax:
Practice Address - Street 1:1029 HOWARD ST
Practice Address - Street 2:SUITE 203
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3877
Practice Address - Country:US
Practice Address - Phone:847-491-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027957122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty