Chatham Dental, Ltd
Dentist, General Practice in Chicago, IL. Organization (NPI-2).
NPI number1477567386
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1477567386
- Entity type
- Organization (NPI-2)
- Legal business name
- Chatham Dental, Ltd
- Organization subpart
- No
- Enumeration date
- Jul 28, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019-020325 | IL | Yes |
Practice location
8544 S Stony Island AveChicago, IL 60617-2248
Phone 773-221-0800 · Fax 773-221-0868
Mailing address
8544 S Stony Island AveChicago, IL 60617-2248
Phone 773-221-0800 · Fax 773-221-0868
Authorized official
Rodney Alan Blaney
Dentist
7732210800
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