Individual
AKI TAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 996-7555
Mailing address
801 S PAULINA ST, CHICAGO, IL 60612-7210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034168
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2021
Last updated
07/11/2023
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