Individual
KALDOUN BARAWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
801 S PAULINA ST RM 119D, CHICAGO, IL 60612-7210
(312) 996-1052
(312) 996-5987
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033283
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019.033283
DENTAL LICENSE
IL
Enumeration date
04/15/2021
Last updated
07/05/2021
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