Individual
CELIA YVONNE MIMMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2555 W 79TH ST, CHICAGO, IL 60652-1729
(773) 434-1515
Mailing address
PO BOX 645, MATTESON, IL 60443-0645
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019029248
IL
Other
Enumeration date
10/09/2012
Last updated
04/16/2021
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