MARYAM GHEISARIFAR

CHICAGO, IL
NPI1831731116
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1223P0700X Dentist, Prosthodontics
(Licence: IL  019.033384)
Enumeration Date2019-10-08
Last Update Date2023-09-25
Business Address
MARYAM GHEISARIFAR
801 S PAULINA ST
CHICAGO, IL 60612-7210
Phone number: 414-808-5822
Mailing Address
MARYAM GHEISARIFAR
500 W SUPERIOR ST UNIT 1205
CHICAGO, IL 60654-8139
Phone number: 414-808-5822
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