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5632 Walnut Ave Apt 1a Downers Grove IL 60516-1069 | |
| (630) 724-7587 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 5632 Walnut Ave Apt 1a, Downers Grove, Illinois |
| Authorized Official Name and Position | Zhaomin Huang (PRESIDENT) |
| Authorized Official Contact | 6307247587 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5632 Walnut Ave Apt 1a Downers Grove IL 60516-1069 Ph: (630) 724-7587 | 5632 Walnut Ave Apt 1a Downers Grove IL 60516-1069 Ph: (630) 724-7587 |
| NPI Number | 1992984694 |
|---|---|
| Provider Enumeration Date | 10/30/2007 |
| Last Update Date | 10/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992984694 | NPI | - | NPPES |
| 1932307279 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
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