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 |
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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 |
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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 |
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Provider Enumeration Date | 07/13/2015 |
Last Update Date | 10/19/2015 |
Identifier | Type | State | Issuer |
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1073997722 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 019027537 (Illinois) | Primary |
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