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General NPI Number Information
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NPI Number | 1548484272
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Entity Type | Individual
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Provider Name | SANDRA YOUNAN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 09/09/2016
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Provider Practice Location Address
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Address Line | 1105 MILWAUKEE AVE.
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City | RIVERWOODS
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State | IL
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Zip | 60015-3512
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Country | US
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Telephone | 847-215-1391
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 MILWAUKEE AVE
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City | RIVERWOODS
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State | IL
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Zip | 60015-3512
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Country | US
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Telephone | 847-215-1391
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019026174
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License Number State | IL
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