Individual
INNA SYDORAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
539 N LA GRANGE RD, LA GRANGE PARK, IL 60526-5647
(708) 354-1070
Mailing address
2222 FULLER CT APT 1109, ANN ARBOR, MI 48105-2392
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019031036
IL
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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