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5109b S Pulaski Rd Chicago IL 60632 | |
| (773) 284-0037 | |
| (773) 284-1663 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5109b S Pulaski Rd, Chicago, Illinois |
| Authorized Official Name and Position | Nihal Bicakci (SECRETARY) |
| Authorized Official Contact | 17732840037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
434 W Briar Pl #2 Chicago IL 60657-4775 Ph: (773) 284-0037 | 5109b S Pulaski Rd Chicago IL 60632 Ph: (773) 284-0037 |
| NPI Number | 1700102951 |
|---|---|
| Provider Enumeration Date | 04/13/2010 |
| Last Update Date | 04/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700102951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026905 (Illinois) | Primary |
| 1223G0001X | Dentist - General Practice | 019026278 (Illinois) | Secondary |
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