Individual
ROHAM KASHANIMOGHADDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6258 S PULASKI RD, CHICAGO, IL 60629-4610
(773) 777-6363
Mailing address
512 N MCCLURG CT APT 3011, CHICAGO, IL 60611-4120
(773) 603-6232
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034372
IL
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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