Individual
DR. EREZ NOSRATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MSD, MSC
Contact information
Practice address
1901 S CALUMET AVE UNIT 2005, CHICAGO, IL 60616-6024
(312) 731-5554
Mailing address
1901 S CALUMET AVE UNIT 2005, CHICAGO, IL 60616-6024
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019028808
IL
1223P0300X
Periodontics
Primary
019028808
IL
Other
Enumeration date
09/07/2011
Last updated
10/11/2012
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