Individual
DR. IRUM TARIQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
820 LARAWAY RD, NEW LENOX, IL 60451-2694
(815) 242-9594
Mailing address
820 LARAWAY RD, NEW LENOX, IL 60451-2694
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019033162
IL
1223G0001X
General Practice Dentistry
019033162
IL
Other
Enumeration date
06/09/2021
Last updated
11/13/2023
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