Individual
ALI JARRAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 N DIRKSEN PKWY, SPRINGFIELD, IL 62702-1407
(217) 717-3293
Mailing address
6924 N ROSEMARY LN, NILES, IL 60714-4459
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031445
IL
1223G0001X
General Practice Dentistry
019.031445
IL
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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