| |
2400 Chicago Rd Chicago Heights IL 60411-4160 | |
(708) 755-2400 | |
(708) 755-2437 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 2400 Chicago Rd, Chicago Heights, Illinois |
Authorized Official Name and Position | Mohammad Al-asadi (PRESIDENT) |
Authorized Official Contact | 7087552400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2400 Chicago Rd Chicago Heights IL 60411-4160 Ph: (708) 755-2400 | 2400 Chicago Rd Chicago Heights IL 60411-4160 Ph: (708) 755-2400 |
NPI Number | 1881087021 |
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Provider Enumeration Date | 03/12/2015 |
Last Update Date | 03/12/2015 |
Identifier | Type | State | Issuer |
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1881087021 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 019025105 (Illinois) | Primary |
261QD0000X | Clinic/center - Dental | 019025105 (Illinois) | Secondary |
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