John M. Formeller, DDS

Dentist · Northbrook, IL

Individual Active NPI

NPI number 1952455107

Practice location

1220 Meadow Rd
Suite 204
Northbrook, IL 60062-3698
Phone
(847) 272-9666

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NPI record

NPI
1952455107
Entity type
Individual (Type 1)
Enumeration date
January 23, 2007
Last updated
December 6, 2016
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019021481 IL

About Dr. Formeller

John M. Formeller, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1220 Meadow Rd, Suite 204, Northbrook, IL 60062-3698. The NPI number 1952455107 was assigned on January 23, 2007 and the record was last updated on December 6, 2016.

Dr. Formeller lists a license in the registry: #019021481 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of John M. Formeller, DDS?

The NPI number is 1952455107.

What is the phone number of Dr. Formeller?

The phone number listed for the practice location is (847) 272-9666.

Where is Dr. Formeller located?

1220 Meadow Rd, Suite 204, Northbrook, IL 60062-3698.

What is the taxonomy code for Dr. Formeller?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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