Individual
DR. IVAN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5501 S HALSTED ST, CHICAGO, IL 60621-2229
(773) 275-2586
Mailing address
5501 S HALSTED ST, CHICAGO, IL 60621-2229
(773) 275-2586
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.030195
IL
1223G0001X
General Practice Dentistry
DN14742
FL
Other
Enumeration date
05/01/2006
Last updated
10/07/2025
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