Individual
DR. NICHOLAS JAMES POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5470 W MADISON ST, CHICAGO, IL 60644-4026
(773) 287-2277
Mailing address
5470 W MADISON ST, CHICAGO, IL 60644-4026
(773) 287-2277
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032285
IL
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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