Individual
DR. RHAY ELLIOTT STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10703 S HALE AVE, CHICAGO, IL 60643-3306
(773) 640-0813
Mailing address
10703 S HALE AVE, CHICAGO, IL 60643-3306
(773) 640-0813
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-023780
IL
1223G0001X
General Practice Dentistry
019023780
IL
Other
Enumeration date
02/04/2007
Last updated
04/30/2021
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