NPI 1285714568

Walter Tatch

Practitioner Oral & Maxillofacial Surgery (D.M.D.) Gurnee, IL

Practice location

Address: 310 S Greenleaf St STE 203, Gurnee, IL 60031-5708
Phone: (847) 623-5915
Fax: (847) 623-1174
Mailing address: 700 Osterman Ave, Deerfield, IL 60015-4375

Registered specialties (2)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 021002076 (IL)

Other Oral & Maxillofacial Surgery providers in Illinois →

Oral and Maxillofacial Surgery (Dentist)

Dental Providers Taxonomy 1223S0112X Licence 021002076 (IL)

Other Dentist providers in Illinois →

Registry record

NPI: 1285714568
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Oct 2006
Record last updated: 16 Dec 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.