Individual
SARAH CATHERINE DEFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4310 S PULASKI RD, CHICAGO, IL 60632-4009
(224) 426-7066
Mailing address
381 SOUTHWIND CT, LAKE VILLA, IL 60046-6687
(224) 426-7066
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033302
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019.033302
—
IL
Enumeration date
07/08/2021
Last updated
07/13/2021
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