Individual
JOSE VALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1536 VINCENNES AVE, CHICAGO HEIGHTS, IL 60411-3458
(708) 709-1044
Mailing address
12006 S HAMLIN AVE, ALSIP, IL 60803-1216
(773) 284-4044
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019023211
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019023211
STATE LICENSE
IL
Enumeration date
04/18/2007
Last updated
07/08/2007
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