Individual
CHANIQUA MCFADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2410 W JEFFERSON ST, 108, JOLIET, IL 60435-6449
(815) 744-4443
(815) 744-4460
Mailing address
2410 W JEFFERSON ST, 108, JOLIET, IL 60435-6449
(815) 744-4443
(815) 744-4460
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030843
IL
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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