Individual
EMILIYA TANEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
73 E LAKE ST APT 3508, CHICAGO, IL 60601-4800
(312) 504-7972
Mailing address
73 E LAKE ST APT 3508, CHICAGO, IL 60601-4800
(312) 504-7972
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
018001794
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019029752
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
021002588
IL
Other
Enumeration date
04/21/2014
Last updated
12/16/2014
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