Individual
PRANEETA THAKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4501 S STATE ST, CHICAGO, IL 60609-3758
(773) 548-0600
Mailing address
555 W MADISON ST, CHICAGO, IL 60661-2514
(636) 439-9440
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032194
IL
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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