Individual
NADA SALEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 DAVIS ST STE 460, EVANSTON, IL 60201-4447
(847) 332-2226
Mailing address
345 E OHIO ST APT 4607, CHICAGO, IL 60611-4574
(919) 995-3868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11373
NC
1223G0001X
General Practice Dentistry
Primary
319.021434
IL
Other
Enumeration date
05/22/2019
Last updated
12/16/2019
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