Individual
JILL HOFFMEYER BASKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
320 LAKE ST, OAK PARK, IL 60302-2612
(708) 848-0528
Mailing address
546 KEYSTONE AVE, RIVER FOREST, IL 60305-1612
(708) 771-3837
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001165
—
IL
Enumeration date
01/19/2007
Last updated
07/09/2007
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