Individual
IRFANA ILYAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2403,5521 S KEDZIE AVE, SUITE 105, CHICAGO, IL 60629
(773) 434-1600
Mailing address
9133 SKOKIE BLVD UNIT 1, SKOKIE, IL 60077-1786
(610) 906-0335
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031589
IL
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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