Individual
DR. JACQUELINE MAGALLANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
7124 W DIVERSEY AVE, CHICAGO, IL 60707-1601
(773) 237-8855
Mailing address
9S616 HIGHLAND RD, WILLOWBROOK, IL 60527-7017
(312) 927-0537
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031220
IL
Other
Enumeration date
07/06/2017
Last updated
03/17/2018
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