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1164900973
ALIAKSANDR SHABANOVICH
CHICAGO, IL
NPI
1164900973
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IL 019.031814)
Enumeration Date
2018-08-02
Last Update Date
2018-08-02
Business Address
ALIAKSANDR SHABANOVICH
5200 S ARCHER AVE
CHICAGO, IL 60632-4772
Phone number: 773-581-1345
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Mailing Address
ALIAKSANDR SHABANOVICH
1416 W CULLERTON ST APT 2R
CHICAGO, IL 60608-3017
Phone number: 347-981-0552
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