Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 019.032120 | IL |
NPI | 1003377961 |
---|---|
Provider Name | Janine Kabir |
First Address | Chicago, IL 60657-5123 |
Second Address | Chicago, IL 60657-5123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2019 |
Last Update Date | 10/12/2019 |