Individual
DR. MICHAELLA RADICH HEITZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1611 N. WOLCOTT AVE, CHICAGO, IL 60622
(312) 281-4860
Mailing address
1611 N. WOLCOTT AVE, CHICAGO, IL 60622
(312) 281-4860
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019.029719
IL
Other
Enumeration date
06/11/2014
Last updated
09/13/2016
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