Individual
DR. IMANI JACQUELINE BEHRENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
820 S WOOD ST., SUITE 100, MC 675, CHICAGO, IL 60612
(312) 996-2933
Mailing address
820 S WOOD ST., SUITE 100, MC 675, CHICAGO, IL 60612
(312) 996-2933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034166
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2022
Last updated
07/12/2024
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