Individual
QIAN XIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 479-4416
Mailing address
901 S ASHLAND AVE APT 806A, CHICAGO, IL 60607-4089
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028749
IL
1223E0200X
Endodontics
021.002416
IL
Other
Enumeration date
08/02/2011
Last updated
08/15/2011
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