Individual
FARIDEH NIKOO DAFTARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3056 N SOUTHPORT AVE, CHICAGO, IL 60657-4218
(773) 935-3600
Mailing address
1733 W NELSON ST, CHICAGO, IL 60657-3028
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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