Individual
DR. RYAN GRELLE TUSCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
5425 W LAKE ST, CHICAGO, IL 60644-2342
(773) 378-3347
(773) 378-4028
Mailing address
1431 N WESTERN AVE, SUITE 401, CHICAGO, IL 60622-1797
(312) 633-5841
(773) 269-5500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028069
IL
Other
Enumeration date
07/13/2009
Last updated
01/02/2020
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