Individual
IBTESAM KAMAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
811 W WELLINGTON AVE, CHICAGO, IL 60657-5123
(773) 871-2188
Mailing address
2917 W BRYN MAWR AVE, CHICAGO, IL 60659-4812
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.035120
IL
Other
Enumeration date
03/25/2024
Last updated
06/18/2024
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