Individual
DR. CHRISTA LOUISE FAVOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(886) 600-2273
Mailing address
1545 N WELLS ST APT 2, CHICAGO, IL 60610-2059
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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