Organization
STEVEN B. RAPHAEL, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN B. RAPHAEL D.D.S. (PRESIDENT)
(913) 723-1313
Entity
Organization
Contact information
Practice address
5780 N LINCOLN AVE, CHICAGO, IL 60659-4721
(773) 769-1754
Mailing address
360 E SOUTH WATER ST, #4102, CHICAGO, IL 60601-4028
(913) 723-1313
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
019.028222
IL
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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