Individual
HERVE Y SROUSSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
809 S MARSHFIELD AVE, 9TH FLOOR (M/C 732), CHICAGO, IL 60612-4305
(312) 996-7699
(312) 996-1001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DF11247
MA
1223G0001X
General Practice Dentistry
136-000107
IL
Other
Enumeration date
10/25/2006
Last updated
03/30/2017
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