IndividualActive
Maryam Gheisarifar
NPI 1831731116 · Prosthodontics · Chicago, IL
Provider details
- NPI number
- 1831731116
- Entity type
- Individual
- Primary specialty
- ProsthodonticsDental Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 019.033384 (IL)
Specialties & taxonomies
Dental Providers
Practice location
801 S Paulina St
Chicago, IL 60612-7210
Phone: (414) 808-5822
Approximate (ZIP-level) locationGet directions
Mailing address
500 W Superior St Unit 1205
Chicago, IL 60654-8139
Registry dates
- Enumerated
- 2019-10-08
- Last updated
- 2023-09-25
- Certified
- 2023-09-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.