Provider Demographics
NPI:1790929800
Name:LIGAS, BOZENA B (DMD)
Entity Type:Individual
Prefix:DR
First Name:BOZENA
Middle Name:B
Last Name:LIGAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 W MADISON ST
Mailing Address - Street 2:APT A3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-2627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2007 W BELMONT AVE
Practice Address - Street 2:SUITE 1E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6792
Practice Address - Country:US
Practice Address - Phone:773-281-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027536122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist