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8114 W 111th St Palos Hills IL 60465-2206 | |
| (708) 974-9550 | |
| (708) 974-1823 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8114 W 111th St, Palos Hills, Illinois |
| Authorized Official Name and Position | Ayesha Khan (CO-OWNER) |
| Authorized Official Contact | 7737505205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8114 W 111th St Palos Hills IL 60465-2206 Ph: (708) 974-9550 | 8114 W 111th St Palos Hills IL 60465-2206 Ph: (708) 974-9550 |
| NPI Number | 1407681810 |
|---|---|
| Provider Enumeration Date | 09/05/2024 |
| Last Update Date | 12/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407681810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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