Dr. Edison A Ishaya, DDS
Dentist, General Practice in Chicago, IL. Individual provider (NPI-1).
NPI number1124156773
StatusActive
Last updated in NPPESJul 9, 2007
Details
- NPI
- 1124156773
- Entity type
- Individual (NPI-1)
- Name
- Dr. Edison A Ishaya
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 2, 2007
- Last updated
- Jul 9, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019024678 | IL | Yes |
Practice location
3855 W North AveChicago, IL 60647-4640
Phone 773-782-8900 · Fax 773-782-0577
Mailing address
3855 W North AveChicago, IL 60647-4640
Phone 773-782-8900 · Fax 773-782-0577
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