Individual
ATHANASIOS NICOLOZAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4560 W 103RD ST, OAK LAWN, IL 60453-4869
(708) 423-5155
Mailing address
4560 W 103RD ST, OAK LAWN, IL 60453-4869
(708) 423-5155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033194
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2021
Last updated
08/22/2022
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