Individual
ELIANORA A LUTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3855 W NORTH AVE, CHICAGO, IL 60647-4640
(773) 782-8900
(773) 782-0577
Mailing address
3855 W NORTH AVE, CHICAGO, IL 60647-4640
(773) 782-8900
(773) 782-0577
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
L35020180940
IL
Other
Enumeration date
09/15/2008
Last updated
12/15/2011
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