Provider Demographics
NPI:1598720856
Name:DRAHOS, EMILY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:DRAHOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6800 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2312
Mailing Address - Country:US
Mailing Address - Phone:773-788-1001
Mailing Address - Fax:773-788-1388
Practice Address - Street 1:6800 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2312
Practice Address - Country:US
Practice Address - Phone:773-788-1001
Practice Address - Fax:773-788-1388
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190256281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice