Individual
ABHISHEK NAGARAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13247 S BALTIMORE AVE, CHICAGO, IL 60633-1431
(773) 646-4664
Mailing address
13247 S BALTIMORE AVE, CHICAGO, IL 60633-1431
(773) 646-4664
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.029975
IL
Other
Enumeration date
07/29/2014
Last updated
08/24/2020
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