Individual
DR. IAN MAHONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
820 S WOOD ST STE 100, CHICAGO, IL 60612-4325
(312) 996-2933
Mailing address
820 S WOOD ST STE 100, CHICAGO, IL 60612-4325
(312) 996-2933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.035351
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019.035351
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2024
Last updated
09/05/2024
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