Individual
NEHA IBNE-RASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
712 E 87TH ST, CHICAGO, IL 60619-6246
(773) 783-9000
Mailing address
903 S ASHLAND AVE APT 315, CHICAGO, IL 60607-4096
(917) 302-1124
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032644
IL
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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