Individual
DR. JANANI KOTESHWARAN GURUKKAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
61 W 144TH ST, RIVERDALE, IL 60827-2850
(708) 419-2204
Mailing address
1326 S MICHIGAN AVE APT 2808, CHICAGO, IL 60605-3527
(615) 852-0170
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.033919
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2021
Last updated
08/21/2022
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