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1871756767
IRENE T. THEODORE
CHICAGO, IL
NPI
1871756767
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019020903)
Enumeration Date
2008-07-09
Last Update Date
2008-07-17
Business Address
Dr. IRENE T. THEODORE dds
4200 W PETERSON AVE SUITE 136
CHICAGO, IL 60646-6074
Phone number: 773-286-5286
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Mailing Address
Dr. IRENE T. THEODORE dds
4200 W PETERSON AVE SUITE 136
CHICAGO, IL 60646-6074
Phone number: 773-286-5286
Copy
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