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General NPI Number Information
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NPI Number | 1669938387
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Entity Type | Individual
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Provider Name | THERESA KARRAS DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 11 E CEDAR ST FLOOR 2
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City | CHICAGO
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State | IL
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Zip | 60611-6066
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Country | US
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Telephone | 312-757-5893
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Fax |
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Provider Business Mailing Address
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Address Line | 5818 DEMPSTER ST
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City | MORTON GROVE
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State | IL
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Zip | 60053-3027
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Country | US
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Telephone | 224-300-0480
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 021002992
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License Number State | IL
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