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1083768113
PHILIP NELSON
CHICAGO, IL
NPI
1083768113
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223D0001X Dentist, Dental Public Health
(Licence: IL 019015620)
Enumeration Date
2007-01-23
Last Update Date
2007-07-08
Business Address
-- PHILIP NELSON
6124 N OVERHILL AVE
CHICAGO, IL 60631-3817
Phone number: 773-763-8202
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Mailing Address
-- PHILIP NELSON
6124 N OVERHILL AVE
CHICAGO, IL 60631-3817
Phone number: 773-763-8202
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