Individual
JOSH MANUEL PHILIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 975-1600
Mailing address
3151 GLENWAY DR, NORTHBROOK, IL 60062-7507
(847) 502-2482
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.031845
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2018
Last updated
10/10/2019
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