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5449 N Broadway St Chicago IL 60640-1703 | |
| (773) 878-1009 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 5449 N Broadway St, Chicago, Illinois |
| Authorized Official Name and Position | Linh Thuy Tran (DENTIST) |
| Authorized Official Contact | 7738781009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5449 N Broadway St Chicago IL 60640-1703 Ph: (773) 878-1009 | 5449 N Broadway St Chicago IL 60640-1703 Ph: (773) 878-1009 |
| NPI Number | 1902063043 |
|---|---|
| Provider Enumeration Date | 05/16/2008 |
| Last Update Date | 05/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902063043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019-026073 (Illinois) | Primary |
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