Individual
TALA GHISHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 996-7555
Mailing address
2 E ERIE ST APT 3609, CHICAGO, IL 60611-3159
(404) 395-0455
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
019.033859
IL
Other
Enumeration date
02/12/2020
Last updated
04/23/2025
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