Jack S. Litz, D.D.S., LTD.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

01912745 Issued in IN

Legal business name

JACK S. LITZ, D.D.S., LTD.

Practice address

6435 S Pulaski Rd
Chicago, IL 60629-5148

Phone

(773) 735-2515

NPI assigned

Oct 4, 2010

Last updated

Oct 4, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jack S. Litz, D.D.S.

Title

President

Phone

(773) 735-2515

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1073822490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6435 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-735-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6435 S PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295148",
            "telephone_number": "773-735-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK S. LITZ, D.D.S., LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "LITZ",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-735-2515",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "01912745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Chicago, IL
• Providers in Chicago, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.