Provider Demographics
NPI:1689737751
Name:RHIM LAVIN, WHAL RAN (DDS)
Entity Type:Individual
Prefix:
First Name:WHAL RAN
Middle Name:
Last Name:RHIM LAVIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9631 WEST 153RD STREET
Mailing Address - Street 2:SUITE 31
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462
Mailing Address - Country:US
Mailing Address - Phone:708-460-7114
Mailing Address - Fax:708-460-7327
Practice Address - Street 1:9631 WEST 153RD STREET
Practice Address - Street 2:SUITE 31
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462
Practice Address - Country:US
Practice Address - Phone:708-460-7114
Practice Address - Fax:708-460-7327
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist