Individual
PAYAM REZAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3927 W BELMONT AVE STE 105, CHICAGO, IL 60618-5170
(847) 502-2127
Mailing address
1901 S CALUMET AVE UNIT 1107, CHICAGO, IL 60616-6008
(847) 502-2127
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028289
IL
Other
Enumeration date
06/17/2010
Last updated
09/23/2013
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