Individual
KISHORI DHAKU BAWDANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 296-5187
(773) 296-8074
Mailing address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 296-5187
(773) 296-8074
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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