| West Loop Family Dental Llc | |
|
1202 W Madison St Chicago IL 60607-1908 | |
| (312) 724-7161 | |
| Not Available |
| Full Name | West Loop Family Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 1202 W Madison St, Chicago, Illinois |
| Authorized Official Name and Position | Ankita Shah (MANAGER) |
| Authorized Official Contact | 8183243315 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Loop Family Dental Llc 1202 W Madison St Chicago IL 60607-1908 Ph: (312) 724-7161 | West Loop Family Dental Llc 1202 W Madison St Chicago IL 60607-1908 Ph: (312) 724-7161 |
| NPI Number | 1073997722 |
|---|---|
| Provider Enumeration Date | 07/13/2015 |
| Last Update Date | 10/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073997722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027537 (Illinois) | Primary |
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