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Organization
VETERANS SQUARE DIAGNOSTICS, INC.
Active
Organization
VETERANS SQUARE DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID KODNER (PRESIDENT)
(773) 622-8700
Entity
Organization
Contact information
Practice address
4849 N MILWAUKEE AVE, SUITE 505, CHICAGO, IL 60630-5100
(773) 622-8700
Mailing address
4849 N MILWAUKEE AVE, SUITE 505, CHICAGO, IL 60630-5100
(773) 622-8700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
01908827
IL
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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