person
Dr. Preston Allen Mercurius Banoub, DMD
Student in an Organized Health Care Education/Training Program in Chicago, Illinois
NPI 1578138376

Preston Allen Mercurius Banoub is a Student in an Organized Health Care Education/Training Program based in Greendale, IL. Preston Allen Mercurius Banoub practices in Chicago, IL and has the professional credentials of DMD. The NPI Number for Preston Allen Mercurius Banoub is 1578138376 and holds a License No. (Illinois).

The current practice location address for Preston Allen Mercurius Banoub is 1900 W Polk St Unit 611, Chicago, IL and can be reached out via phone at 312-864-0200.

Location: 1900 W Polk St Unit 611, Chicago, IL, 53129-2853
person
Provider Profile Details
NPI Number
1578138376
Provider Name
Preston Allen Mercurius Banoub
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
1900 W Polk St Unit 611, Chicago, IL, 53129-2853
Phone Number
312-864-0200
Fax Number
Provider Enumeration Date
05/24/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1900 W Polk St Unit 611
City
State
Zip
60612-3723
Phone Number
312-864-0200
Fax Number
person
Provider Business Mailing Address Details
Address
1900 W Polk St Unit 611
City
State
Zip
60612-3723
Phone Number
312-864-0200
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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