Individual
MANAL IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6228 N KEYSTONE AVE, CHICAGO, IL 60646
(812) 223-2242
Mailing address
6228 N KEYSTONE AVE, CHICAGO, IL 60646-5112
(812) 223-2242
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031319
IL
Other
Enumeration date
08/18/2017
Last updated
07/21/2022
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