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General NPI Number Information
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NPI Number | 1932349248
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Entity Type | Individual
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Provider Name | ALALEH DOWLATSHAHI DDS
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Gender | Female
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 02/26/2009
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Provider Practice Location Address
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Address Line | 3210 W 63RD ST
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City | CHICAGO
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State | IL
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Zip | 60629-3325
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Country | US
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Telephone | 312-274-0308
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 S SANGAMON STREET APT 617
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City | CHICAGO
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State | IL
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Zip | 60608-2241
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Country | US
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Telephone | 312-388-0109
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.027868
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License Number State | IL
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