Jason Fowler, D.D.S

NPI 1417205873 · on the registry since 2012 · sole proprietor

Practice

Address: 2410 Sampson St
Bldg. 237
Great Lakes, IL 60088
Phone: (847) 688-3331
Organisation at this address: James A Lovell Federal Health Care Center
James A Lovell Federal Health Care Center
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 33

Registry record

Primary taxonomy: 122300000X
122300000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-08-16

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois