Individual
DR. JOANNA KALAW BASAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1426 W BELMONT AVE, CHICAGO, IL 60657-6898
(773) 528-0068
Mailing address
1426 W BELMONT AVE, CHICAGO, IL 60657-5346
(773) 528-0068
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019029091
IL
1223G0001X
General Practice Dentistry
019029091
IL
Other
Enumeration date
07/02/2012
Last updated
06/13/2017
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