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Individual

MINATI MUKHERJEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S., M.S.

Contact information

Practice address
2720 W 15TH ST, CHICAGO, IL 60608-1610
(773) 257-6485
Mailing address
2720 W 15TH ST, CHICAGO, IL 60608-1610
(773) 257-6485

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003068
PROVIDER ID NUMBER
IL
Enumeration date
10/21/2005
Last updated
07/08/2007
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