| Chicago Oral Medicine | |
|
10763 163rd Place Orland Park IL 60467 | |
| (517) 214-4034 | |
| Not Available |
| Full Name | Chicago Oral Medicine |
|---|---|
| Speciality | Dentist |
| Location | 10763 163rd Place, Orland Park, Illinois |
| Authorized Official Name and Position | Bassam Ali Issa (PRESEIDENT) |
| Authorized Official Contact | 5172144034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Oral Medicine 10763 163rd Pl Orland Park IL 60467-8861 Ph: (517) 214-4034 | Chicago Oral Medicine 10763 163rd Place Orland Park IL 60467 Ph: (517) 214-4034 |
| NPI Number | 1891031647 |
|---|---|
| Provider Enumeration Date | 12/26/2012 |
| Last Update Date | 12/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891031647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019029193 (Illinois) | Primary |
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