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Individual

DR. PHILIP RUTKOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1514 TORRENCE AVE, CALUMET CITY, IL 60409-5409
(708) 891-8569
Mailing address
123 N DESPLAINES ST APT 1614, CHICAGO, IL 60661-2327
(248) 217-5004

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019.029938
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002967
IL

Other

Enumeration date
08/12/2014
Last updated
09/12/2019
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