| Oral & Maxillofacial | |
|
25 E Washington St Ste 825 Chicago IL 60602-1722 | |
| (773) 296-7645 | |
| (773) 295-1023 |
| Full Name | Oral & Maxillofacial |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 25 E Washington St Ste 825, Chicago, Illinois |
| Authorized Official Name and Position | Mohammed Qaisi (OWNER) |
| Authorized Official Contact | 7732967645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral & Maxillofacial 25 E Washington St Ste 825 Chicago IL 60602-1722 Ph: (773) 296-7645 | Oral & Maxillofacial 25 E Washington St Ste 825 Chicago IL 60602-1722 Ph: (773) 296-7645 |
| NPI Number | 1730898933 |
|---|---|
| Provider Enumeration Date | 11/16/2022 |
| Last Update Date | 11/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730898933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Secondary |
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