Individual
ESTHER PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2822 N ASHLAND AVE, CHICAGO, IL 60657-4002
(773) 871-0302
Mailing address
701 S CARPENTER ST UNIT D, CHICAGO, IL 60607-3725
(630) 456-2162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.037352
IL
Other
Enumeration date
07/22/2026
Last updated
07/22/2026
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