Most Relevant Information
Provider Data
| NPI Number: | 1003469636 |
| Provider Name: | AHMED MANSOUR |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 019032164 |
Most Important Dates
| Enumeration Date: | 07/23/2019 |
| Last Updated: | 07/23/2019 |
Provider Practice Location
2122 N MILWAUKEE AVE STE 1
CHICAGO
IL
606474251
Practice Location Phone/Fax
| Phone: | 7732271245 |
| Fax: |
Provider Mailing Location
502 N ADDISON RD
VILLA PARK
IL
601811431
Provider Mailing Phone/Fax
| Phone: | 6309367997 |
| Fax: |