1497870554 NPI number — DR. SAHAR MOHAMMAD ADNAN ALRAYYES DDS, MS

Table of content: DR. SAHAR MOHAMMAD ADNAN ALRAYYES DDS, MS (NPI 1497870554)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497870554 NPI number — DR. SAHAR MOHAMMAD ADNAN ALRAYYES DDS, MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALRAYYES
Provider First Name:
SAHAR
Provider Middle Name:
MOHAMMAD ADNAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS, MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497870554
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65 EAST SCOTT STREET
Provider Second Line Business Mailing Address:
APT # 9A
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-475-1747
Provider Business Mailing Address Fax Number:
312-996-1981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 SOUTH PAULINA MC 850
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-996-6414
Provider Business Practice Location Address Fax Number:
312-996-1981
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  019024867 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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