Individual
DR. MONIQUE CURRIE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2133 S 17TH AVE, BROADVIEW, IL 60155-3019
(708) 865-0200
(708) 865-1730
Mailing address
301 THATCHER AVE, RIVER FOREST, IL 60305-2031
(708) 865-0200
(708) 865-1730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-023803
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004349
—
IL
05
—
170373
—
IL
Enumeration date
01/20/2007
Last updated
07/09/2007
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