Individual
DR. GHASSAN SOURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2750 W NORTH AVE, CHICAGO, IL 60647-5247
(312) 432-4541
(773) 342-3204
Mailing address
2750 W NORTH AVE, CHICAGO, IL 60647-5247
(312) 432-4541
(773) 342-3204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019022067
IL
Other
Enumeration date
07/22/2006
Last updated
08/06/2010
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