Individual
SHAHRBANOO FADAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.,M.S.
Contact information
Practice address
4833 CHURCH ST, 801 S. POLINA, SKOKIE, IL 60077-1357
(847) 673-7118
Mailing address
2429 MEADOW DR N, WILMETTE, IL 60091-2253
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
IL
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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