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Individual

DR. JOSEPH POWERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
641 W 63RD ST, CHICAGO, IL 60621-2032
(708) 431-4724
Mailing address
641 W 63RD ST, CHICAGO, IL 60621-2032
(708) 431-4724

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031627
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019031627
IL
Enumeration date
06/09/2018
Last updated
06/02/2023
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