Individual
CAROLYN ANN CONDIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2424 S PULASKI RD, CHICAGO, IL 60623-3718
(773) 521-0750
Mailing address
4848 S DREXEL BLVD APT 2W, CHICAGO, IL 60615-1708
(773) 655-5722
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020011855
IL
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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