Individual
IRENA TODOROVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4608 W DIVERSEY AVE, CHICAGO, IL 60639-1801
(773) 481-2200
Mailing address
402 WESLEY AVE, OAK PARK, IL 60302-3987
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019030840
IL
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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