Organization
CHICAGO OSTEOPATHIC HOSPITAL DENTAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANA C HERNANDEZ (OFFICE MANAGER)
(773) 947-4665
Entity
Organization
Contact information
Practice address
1525 E. 53RD ST., #522, CHICAGO, IL 60615-4530
(773) 947-4665
(773) 256-2373
Mailing address
1525 E. 53RD ST., #522, CHICAGO, IL 60615-4530
(773) 947-4665
(773) 256-2373
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019022626
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101659
—
IL
Enumeration date
10/02/2006
Last updated
06/11/2008
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