IndividualActive
Walter Tatch
NPI 1285714568 · Oral & Maxillofacial Surgery (D.M.D.) · Gurnee, IL
Provider details
- NPI number
- 1285714568
- Entity type
- Individual
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- Yes
- License
- 021002076 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Dental Providers
Practice location
310 S Greenleaf St Ste 203
Gurnee, IL 60031-5708
Phone: (847) 623-5915
Fax: (847) 623-1174
Approximate (ZIP-level) locationGet directions
Mailing address
700 Osterman Ave
Deerfield, IL 60015-4375
Additional practice locations (2)
- 700 Osterman AveDeerfield, IL 60015-4375Phone: (847) 623-5915
- 1900 Hollister Dr Ste 280Libertyville, IL 60048-5260Phone: (847) 623-5915
Registry dates
- Enumerated
- 2006-10-17
- Last updated
- 2024-12-16
- Certified
- 2024-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.