Individual
DR. INTHUMATHY SIVANANTHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M
Contact information
Practice address
2783 MAPLE AVE, LISLE, IL 60532
(630) 857-3444
(630) 857-3056
Mailing address
2783 MAPLE AVE, LISLE, IL 60532
(630) 857-3444
(630) 857-3056
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023413
IL
Other
Enumeration date
02/22/2007
Last updated
04/25/2019
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